Cold-induced urticaria associated with type I cryoglobulinemia, successfully treated with rituximab

Stroet, Leonie C.; Hermans, Maud A.W.; Maurer, Marcus; Doorn, Martijn van

doi:10.1016/j.jdcr.2021.10.032

Cited by 2 publications

(3 citation statements)

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“…Novel and better treatment options for patients with ColdU are needed, and several are currently being explored or in clinical development. 12 , 18 , 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

“…Novel and better treatment options for patients with ColdU are needed, and several are currently being explored or in clinical development. 12,[18][19][20][21] Different systemic autoinflammatory diseases present with coldinduced wheals. The best known entity is cryopyrin-associated periodic syndrome (CAPS), for which IL-1-targeting drugs have been shown to be highly effective.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, omalizumab is not approved for ColdU, and not all ColdU patients treated with omalizumab show improvement. Novel and better treatment options for patients with ColdU are needed, and several are currently being explored or in clinical development 12,18–21 …”

Section: Introductionmentioning

confidence: 99%

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Inhibition of interleukin‐1 with rilonacept is not effective in cold urticaria—Results of a randomized, placebo‐controlled study

Bonnekoh

Butze

Spittler

et al. 2023

Clinical & Translational All

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Background Cold urticaria (ColdU) is characterized by pruritic wheals following exposure of the skin to cold. Many patients show insufficient response to antihistamines, the first line treatment. Based on the high efficacy of interleukin‐1(IL‐1)‐inhibition in cold‐induced urticarial autoinflammatory diseases, we assessed the effects of rilonacept, an IL‐1 inhibitor, in ColdU patients unresponsive to standard treatment. Methods In this randomized, double‐blind, placebo‐controlled two‐center study, we included 20 patients with ColdU. In the first part, patients received 320 mg rilonacept or placebo (1:1) followed by weekly doses of 160 mg rilonacept or placebo for 6 weeks. In the second part, all patients received weekly 160 mg or 320 mg rilonacept for 6 weeks, open‐label. The primary endpoint was change in critical temperature threshold (CTT). Secondary endpoints included changes in quality of life impairment (Dermatology Life Quality Index, DLQI), differences of inflammatory mediators upon cold provocation and safety assessment over the study period. Results Baseline mean CTTs were 20.2°C (placebo) and 17.3°C (rilonacept). Mean CTTs did not change significantly during the 6‐week double‐blind treatment (placebo – 0.45°C; rilonacept +0.89°C). IL‐6, IL‐18 and HSP‐70 blood levels showed interindividual variability without significant changes during hand cold water bath provocation in placebo‐ or rilonacept‐treated patients. In contrast, DLQI significantly improved in the rilonacept (mean DLQI reduction of 3.8; p = 0.002) but not in the placebo group (mean DLQI reduction of 0). Comparing baseline with the rilonacept open‐label treatment, there were no changes in CTTs or DLQI scores. Conclusion IL‐1 inhibition with rilonacept did not improve ColdU, but demonstrated a good safety profile. Clinical Trial Registration EudraCT number: 2012‐005726‐30. ClinicalTrials.gov identifier: NCT02171416.

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“…Novel and better treatment options for patients with ColdU are needed, and several are currently being explored or in clinical development. 12 , 18 , 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%