Ligelizumab for the treatment of chronic spontaneous urticaria

Wedi, Bettina

doi:10.1080/14712598.2020.1767061

Cited by 12 publications

(9 citation statements)

References 58 publications

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“…As regards the safety profile, no serious adverse events were reported in around 900 individuals treated with ligelizumab [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, around 30–40% of patients do not achieve disease control (UAS ≤ 6) with omalizumab [ 26 , 27 , 125 ]. This might be due to the standard dose of omalizumab, not adapted to weight and IgE levels, as seen in asthma, and/or high IgE levels (>1500 IU/mL), and/or different pathogenic mechanisms [ 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 ,…”

Section: Discussionmentioning

confidence: 99%

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Monoclonal Antibodies in Treating Chronic Spontaneous Urticaria: New Drugs for an Old Disease

Manti

Giallongo

Papale

et al. 2022

JCM

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Background: H1-antihistamines (H1AH) represent the current mainstay of treatment for chronic spontaneous urticaria (CSU). However, the response to H1AH is often unsatisfactory, even with increased doses. Therefore, guidelines recommend the use of omalizumab as an add-on treatment in refractory CSU. This paved the way for the investigation of targeted therapies, such as monoclonal antibodies (mAbs), in CSU. Methods: A literature review was conducted including papers published between 2009 and 2022 and ongoing trials about the efficacy and safety of mAbs as treatment for CSU. Results: Twenty-nine articles, a trial with preliminary results, and seventeen ongoing or completed clinical trials on the use of mAbs in CSU were included. Randomized controlled trials (RCTs), meta-analysis, and real-life studies have proven the effectiveness and safety of omalizumab as a third-line treatment in refractory CSU. However, a percentage of patients remain unresponsive to omalizumab. Therefore, other mAbs, targeting different pathways, have been used off-label in case series and others are under investigation in RCTs. Most of them have showed promising results. Conclusions: Omalizumab remains the best choice to treat refractory CSU. Although results from other mAbs seem to be encouraging to achieve symptom control in refractory CSU, thus improving patients’ QoL, RCTs are needed to confirm their effectiveness and safety.

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“…As regards the safety profile, no serious adverse events were reported in around 900 individuals treated with ligelizumab [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Monoclonal Antibodies in Treating Chronic Spontaneous Urticaria: New Drugs for an Old Disease

Manti

Giallongo

Papale

et al. 2022

JCM

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“…Although urticaria is mainly characterized by a histaminergic nature, clinical data indicate that both histaminergic and non-histaminergic components may be involved in the development of pruritus in CU. Indeed, second generation antihistamines are recommended to be the first choice to alleviate itch ( Hon et al, 2019 ), and, if they remain ineffective in spite of the elevation of their dose, administration of IgE-neutralizing antibodies (e.g., Omalizumab or the more effective Ligelizumab) ( Wedi, 2020 ), corticosteroids, leukotriene receptor antagonists (e.g., montelukast), Cyclosporine A, or even certain antidepressants and anti-inflammatory drugs should be considered ( Hon et al, 2019 ).…”

Section: Pruritic Diseasesmentioning

confidence: 99%

Pruritus: A Sensory Symptom Generated in Cutaneous Immuno-Neuronal Crosstalk

et al. 2022

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Pruritus or itch generated in the skin is one of the most widespread symptoms associated with various dermatological and systemic (immunological) conditions. Although many details about the molecular mechanisms of the development of both acute and chronic itch were uncovered in the last 2 decades, our understanding is still incomplete and the clinical management of pruritic conditions is one of the biggest challenges in daily dermatological practice. Recent research revealed molecular interactions between pruriceptive sensory neurons and surrounding cutaneous cell types including keratinocytes, as well as resident and transient cells of innate and adaptive immunity. Especially in inflammatory conditions, these cutaneous cells can produce various mediators, which can contribute to the excitation of pruriceptive sensory fibers resulting in itch sensation. There also exists significant communication in the opposite direction: sensory neurons can release mediators that maintain an inflamed, pruritic tissue-environment. In this review, we summarize the current knowledge about the sensory transduction of pruritus detailing the local intercellular interactions that generate itch. We especially emphasize the role of various pruritic mediators in the bidirectional crosstalk between cutaneous non-neuronal cells and sensory fibers. We also list various dermatoses and immunological conditions associated with itch, and discuss the potential immune-neuronal interactions promoting the development of pruritus in the particular diseases. These data may unveil putative new targets for antipruritic pharmacological interventions.

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“…However, it appears to be less effective than when administered for chronic spontaneous urticaria [21]. Whether ligelizumab is also useful in other diseases in which off-label treatment with omalizumab has proven successful, such as allergic rhinitis [46], difficulties in initiating specific immunotherapy [47], nasal polyposis [48], mastocytosis [49] and also bullous pemphigoid [50], systemic lupus erythematosus [51] or Morbus Morbihan [52] require clarification in the future.…”

Section: Management Of Chronic Spontaneous Urticaria With Omalizumab ...mentioning

confidence: 99%

Current and Future Approaches in Management of Chronic Spontaneous Urticaria Using Anti-IgE Antibodies

et al. 2022

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Chronic spontaneous urticaria (CSU) considerably alters patients’ quality of life, often for extended periods, due to pruriginous skin lesions, impaired sleep, unexpected development of angioedema, and failure of conventional treatments in properly controlling signs and symptoms. Recent research focused on the development of new therapeutic agents with higher efficacy. Although the production of specific immunoglobulin E (IgE) antibodies against certain allergens is not a characteristic of the disease, treatment with omalizumab, a monoclonal anti-IgE antibody, proved efficient and safe in patients with moderate to severe chronic spontaneous urticaria uncontrolled by H1-antihistamines. Ligelizumab, a high-affinity monoclonal anti-IgE antibody, may also efficiently relieve symptoms of unresponsive chronic urticaria to standard therapies. This comprehensive review aims to present recently acquired knowledge on managing chronic spontaneous urticaria with new anti-IgE antibodies. We conducted extensive research on the main databases (PubMed, Google Scholar, and Web of Science) with no restrictions on the years covered, using the search terms “anti-IgE antibodies”, “omalizumab”, “ligelizumab”, and “chronic spontaneous urticaria”. The inclusion criteria were English written articles, and the exclusion criteria were animal-related studies. ClinicalTrials.gov was also reviewed for recent relevant clinical trials related to CSU treatment. CSU is a challenging disease with a significant effect on patients’ quality of life. Current therapies often fail to control signs and symptoms, and additional treatment is needed. New biologic therapies against IgE antibodies and FcεRIα receptors are currently under investigation in advanced clinical trials. We reviewed recently published data on CSU management using these novel treatments. The development of new and improved treatments for CSU will lead to a more personalized therapeutical approach for patients and provide guidance for physicians in better understanding disease mechanisms. However, some agents are still in clinical trials, and more research is needed to establish the safety and efficacy of these treatments.

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Ligelizumab for the treatment of chronic spontaneous urticaria

Cited by 12 publications

References 58 publications

Monoclonal Antibodies in Treating Chronic Spontaneous Urticaria: New Drugs for an Old Disease

Monoclonal Antibodies in Treating Chronic Spontaneous Urticaria: New Drugs for an Old Disease

Pruritus: A Sensory Symptom Generated in Cutaneous Immuno-Neuronal Crosstalk

Current and Future Approaches in Management of Chronic Spontaneous Urticaria Using Anti-IgE Antibodies

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