Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature

Tonacci, Alessandro; Billeci, Lucia; Pioggia, Giovanni; Navarra, Michele; Gangemi, Sebastiano

doi:10.1002/phar.1915

Cited by 43 publications

(27 citation statements)

References 65 publications

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“…The current dosage criteria for omalizumab in Italy is 300 mg subcutaneously every 4 weeks in patients who (1) are aged > 12 years, (2) have a urticarial activity score (UAS) of > 3 or a UAS7 (urticarial activity score over 7 days) > 16, and (3) are unresponsive to a 4 times increased dosage of antihistamines [7, 8]. The treatment is administered over two cycles; the first one is 24 weeks, followed by an 8-week “wait and see” period, after which the second cycle is administered for 20 weeks [8]. Additional treatment cycles are considered not approved use, in apparent contradiction with the chronic behaviour of CU.…”

Section: Methodsmentioning

confidence: 99%

Omalizumab in Chronic Urticaria: An Italian Survey

Damiani

Diani

Conic

et al. 2018

Int Arch Allergy Immunol

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Omalizumab is approved for use in chronic spontaneous urticaria (CSU); however, it is not approved for chronic inducible urticaria (CIndU). The aim of the present study was to assess the effectiveness of omalizumab in treating CSU and CIndU in Italy. This is a multicentre prospective observational real-life study involving patients with severe urticaria capable of undergoing omalizumab therapy. We enrolled 127 patients (59.1% females), ranging in age from 15 to 83 years, 69.3% had CSU alone, 26.8% had CSU and CIndU, and 3.9% had only CIndU (30.8% delayed pressure, 35.9% dermographic, 15.3% cholinergic, 12.8% cold, 5.1% aquagenic). After the first cycle of omalizumab (300 mg every 4 weeks for 24 weeks), 16 CSU patients and 10 patients (20.5%) with CIndU with or without CSU did not require a second cycle of omalizumab (300 mg every 4 weeks for 20 weeks). The patient with aquagenic urticaria achieved remission after the first cycle. None showed a lack of response to the second cycle of omalizumab. Omalizumab is a promising drug for both spontaneous and inducible chronic urticaria. Current evidence indicates that omalizumab may be approved also for CIndU.

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Section: Methodsmentioning

confidence: 99%

Omalizumab in Chronic Urticaria: An Italian Survey

Damiani

Diani

Conic

et al. 2018

Int Arch Allergy Immunol

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“…1 CIU lays a heavy burden on the health conditions of its patients as it shares resemblant damage to ischemic heart disease. 1 CIU lays a heavy burden on the health conditions of its patients as it shares resemblant damage to ischemic heart disease.…”

Section: Introductionmentioning

confidence: 99%

MicroRNA‐194 reduces inflammatory response and human dermal microvascular endothelial cells permeability through suppression of TGF‐β/SMAD pathway by inhibiting THBS1 in chronic idiopathic urticaria

Yang

Liu

2019

J of Cellular Biochemistry

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Chronic idiopathic urticaria (CIU) is a polyetiological dermatologic disease. Reports have stated that some microRNAs (miRNAs) have their roles to play in inflammatory response. In this present study, we aim to investigate whether miR‐194 has an effect on attenuating inflammatory response and human dermal microvascular endothelial cells (HDMECs) permeability of CIU mast cells through TGF‐β/SMAD pathway by binding to thrombospondin 1 (THBS1). The Gene Expression Omnibus database was used to obtain the CIU‐related microarray data, and then the analysis of differentially expressed genes was conducted and the miRNA regulated by THBS1 was predicted. After transfection of different mimic, inhibitor, or small interfering RNA, the effect of miR‐194 on inflammatory reaction, mast cell degranulation, histamine release rate, HDMECs permeability, and the expression of THBS1, interferon γ (IFN‐γ), TGF‐β, Smad3, and interleukin 4 (IL‐4) were detected. THBS1 was verified to be the miR‐194 target. After transfected with overexpressed miR‐194 and si‐THBS1, the degranulation rate, histamine release rate, and HDMECs permeability were significantly reduced, while the expression of IFN‐γ was higher, and the expression of THBS1, TGF‐β, Smad3, IL‐4 was significantly lower, accompanied with alleviated inflammatory reaction. Our study provides evidence that miR‐194 negatively modulates THBS1 and inhibits the activation of TGF‐β/SMAD pathway, thereby alleviating the inflammatory response and HDMECs permeability of mast cells in CIU.

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“…Stabilization of basophils cause a decrease in inflammatory cytokines and mediator release, and skin inflammatory processes diminish as a consequence. This overall effect is important, especially in the first phase of the treatment period, owing to downregulation of FcεRI on basophils being faster than that of mast cells 17 . A summary of potential mechanisms of action of omalizumab are shown in Table 1 18,19 .…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

Omalizumab in chronic urticaria: A comprehensive review

Kocatürk¹,

Kızıltaç²,

Leslie³

2018

TURKDERM

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Humanize monoklonal anti-immunoglobulin E antikoru olan omalizumab ilk kez alerjik solunum yolu hastalıklarının tedavisi için geliştirilmiş olup 2014 yılında antihistamin dirençli kronik spontan ürtiker tedavisi için onay almıştır. Henüz indüklenebilir ürtikerin tedavisinde onaylanmamış olmasına rağmen tüm kronik ürtiker (KÜ) alt tiplerinde başarılı bir şekilde uygulanmaktadır. Klinik çalışmalarda ve gerçek yaşam verilerinde bildirilen hafif yan etkiler güvenli bir ilaç olduğunu düşündürmektedir. KÜ'deki kullanımına ait cevaplanmamış sorular kullanım süresi, tedavinin nasıl kesileceği ve uzun dönem yan etkileridir. Bu derlemede bu sorulara ilişkin cevaplar verilmeye çalışılmaktadır. Anahtar Kelimeler: Omalizumab, kronik ürtiker, fiziksel ürtiker, tedaviOmalizumab is a humanized monoclonal anti-immunoglobulin E which is originally developed for the treatment of allergic respiratory disorders, but has been approved for the treatment of antihistamine-resistant chronic spontaneous urticaria in 2014. It has become a game changer in the treatment of all subtypes of chronic urticaria (CU) even though it has not been yet approved for inducible urticarias. It is a safe drug with minor adverse events reported in the clinical trials as well as real life studies. The main questions that remain to be answered regarding its use for CU are the duration of treatment, how to cease the treatment and safety of long-term use. Available information about these questions are tried to be provided in this review. AbstractOmalizumab acts by preventing the binding of IgE to the high-affinity receptors (FcεRI) on mast cells and basophils 4 . Its efficacy has been demonstrated in antihistamine-resistant CSU patients by case reports, case series, observational studies, and randomized placebo-controlled studies [5][6][7][8][9][10][11] . It is the only approved add-on treatment for CSU patients aged 12 years or older who do not respond to H1 antihistamines in both Europe and the US 12 . The efficacy of omalizumab has not only been demonstrated in autoimmune urticaria, but also in the physical, cholinergic, and other forms of urticaria 13 . It has been approved for the treatment of antihistamine-resistant CSU/chronic idiopathic urticaria (CIU)

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Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature

Cited by 43 publications

References 65 publications

Omalizumab in Chronic Urticaria: An Italian Survey

Omalizumab in Chronic Urticaria: An Italian Survey

MicroRNA‐194 reduces inflammatory response and human dermal microvascular endothelial cells permeability through suppression of TGF‐β/SMAD pathway by inhibiting THBS1 in chronic idiopathic urticaria

Omalizumab in chronic urticaria: A comprehensive review

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