Efficacy and Safety of Biologic Agents in Chronic Urticaria, Asthma and Atopic Dermatitis – A Real-life Experience

Abstract

Introduction: Several biologic agents have been approved for the treatment of asthma, chronic urticaria and atopic dermatitis. These therapeutic agents are especially useful for patients with severe or refractory symptoms. We present the real-life experience of four of the commonly used biologic agents in the United Arab Emirates. Methods: In this retrospective observational study, we reviewed the demographic, clinical, laboratory and treatment parameters for all patients treated with biologic agents. Results: 270 patients received biologics at our centre between May 2015 and December 2019 with a median age of 36.5 years. Omalizumab was the most prescribed agent (n=183, 67.8%) followed by dupilumab (n=54, 20%), benralizumab (n=22, 8.1%) and mepolizumab (n=11, 4.1%). Urticaria was the commonest treatment indication (n=148, 55%) followed by asthma (n=105, 39%) and atopic dermatitis (n=13, 5%). All chronic urticaria patients were treated with omalizumab and showed improvement in the mean urticaria control test score from 6.7±4.47 to 12.02±4.17, with a p-value of 0.001. Dupilumab was found to be the most commonly prescribed drug for asthma (37%), followed by omalizumab (32%), benralizumab (21%) and mepolizumab (10%). The mean Asthma control test score for all asthmatics combined increased from 17.06 ± 5.4 to 19.44 ± 5.6, with p-value 0.0012 with treatment; FeNO reduced from 60.02 ± 45.74 to 29.11 ± 27.92, with p-value 0.001 and mean FEV1 improved from 2.38L ± 0.8 to 2.67L ± 0.78, with p-value 0.045. Only 4 patients in the entire cohort reported adverse events. Conclusion: Our study demonstrated that biological agents are a safe and effective treatment for atopic asthma, chronic urticaria and atopic dermatitis.

Understanding Differential Response to Biologic Therapies in Severe Asthma: Retrospective study

“…Similarly, patients with urticaria and rhinosinusitis exhibited substantially decreased risks of nonresponse (p = 0.037 and < 0.001, respectively), suggesting that these comorbidities potentially serve as predictive indicators for positive treatment outcomes. This aligns with the findings of other studies exploring the effectiveness of the use of biological agents for the treatment of different allergic diseases, such as urticaria and rhinosinusitis 24 .…”

Artificial intelligence processing electronic health records to identify commonalities and comorbidities cluster at Immuno Center Humanitas

“…Another potential benefit of this approach lies in its potential ability to save resources and improve pharmacological management of patients by using the same drugs 34 , 35 , 36 , 37 , 38 to treat pathologies normally treated by physicians in different branches of medicine.…”

Omalizumab: An Optimal Choice for Patients with Severe Allergic Asthma

“…Overall, the safety profile was consistent with the current label. Newly recognized adverse effects such as malignant neoplasms, relapsing herpes labialis, pyrexia, fatigue, chest pain, nausea, arthralgia, myalgia, type 1 hypersensitivity, angioedema, metrorrhagia and abortion were reported (Table S2) [146][147][148][149][150][151][152][153].However, the relative risk ratio for these adverse events seems to be very low [32,70,73,92,[154][155][156][157][158][159][160][161][162][163][164]. In several observational studies the percentage of adverse events varies between 2.5% and 32.9% [31,33,35,66,71,94,95,97,115,165,166], the percentage of serious adverse events varies between 0.0% and 16.1% [30,33,66,71,95,97,115,167] and the rate of drug discontinuation due to an adverse event varies between 0.0% and 12.5% [30,33,…”

“…Patients with severe allergic asthma often experience a significant decline in lung function. Despite the fact that some studies have not found a significant improvement in forced expiratory volume in 1 s (FEV1) after the initiation of omalizumab [118,166,[183][184][185][186][187][188][189], the majority of the studies have exhibited a significant improvement in FEV1 after the initiation of omalizumab in asthmatic patients both as a whole [17,29,32,33,59,60,67,73,81,86,119,152,153,158,162,173,[190][191][192][193][194][195][196][197][198], and in specific groups such as children [199], obese patients [200], patients with fixed airway obstruction [201], patients with various co-morbidities [202], and even non-atopic patients with asthma [87]. Similar improvements after the initiation of omalizumab have also been observed in forced vital capacity (FVC) [33,203], FEV1/FVC ratio [59,73], peak expiratory flow (PEF) [19,86,…”