Omalizumab for treatment of idiopathic angioedema

Goswamy, Vinay; Lee, Kristine E.; McKernan, Elizabeth M; Fichtinger, Paul S.; Mathur, Sameer K.; Viswanathan, Ravi

doi:10.1016/j.anai.2022.07.017

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Five trials 23 , 25 , 27 , 30 , 32 randomized 1609 patients and evaluated the percentage of ISS7 MID responders. A statistically significant beneficial effect was found from omalizumab group [RR 1.50, 95% CI (1.36, 1.66), I 2 = 33%].…”

Section: Resultsmentioning

confidence: 99%

Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis

Qin,

Xiao,

Qin

et al. 2024

World Allergy Organization Journal

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Section: Resultsmentioning

confidence: 99%

Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis

Qin,

Xiao,

Qin

et al. 2024

World Allergy Organization Journal

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“…The X-ACT study ( N = 91) found that by week 28, omalizumab was superior to placebo for improvement in Chronic Urticaria Quality of Life Questionnaire scores, and also improved angioedema-burdened days/week, median time to first recurrence of angioedema, and angioedema-specific quality of life [ 87 ]. However, to date, few studies have specifically assessed whether omalizumab is effective for patients with CSU with isolated angioedema, even though there is some evidence of effectiveness from case reports [ 79 ] and one small placebo-controlled trial [ 88 ]—this should be a focus of future work.…”

Section: Omalizumabmentioning

confidence: 99%

Omalizumab for Patients with Chronic Spontaneous Urticaria: A Narrative Review of Current Status

Casale,

Gimenez-Arnau,

Bernstein

et al. 2023

Dermatol Ther (Heidelb)

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Chronic spontaneous urticaria (CSU) is a debilitating inflammatory disorder of the skin, characterized by a fluctuating natural history, a complex mechanism of action, and a significant burden on patients, including effect on quality of life, development of psychosocial disorders, and a range of comorbidities. Recent international guidelines recommend a therapeutic approach of first-line treatment with second generation H1-antihistamines and second-line treatment with the biologic omalizumab. Here, the salient aspects of CSU and current status of data for omalizumab for patients with CSU are reviewed, with a focus on mechanism of action, efficacy and real-world effectiveness (including patient outcomes, response, relapse, and remission), and safety (including consideration of the risk of anaphylaxis). The review also considers recent data on COVID-19, CSU, and omalizumab and presents our perspective on future needs. Overall, the data suggest that omalizumab is an effective and well-tolerated treatment for patients with CSU that provides benefits for a wide range of patients.

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“…43 Recently, a prospective study found a higher complete response rate to omalizumab treatment in four out of five patients with InH-AAE within 24 weeks of treatment. 44 Together, the data indicate the effectiveness of omalizumab in patients with idiopathic AE, but also underlines that a substantial part of the patients still experience symptoms despite treatment.…”

Section: The Presence Of Wheals Has No Influence On the Response To T...mentioning

confidence: 74%

“…42 Effectiveness of omalizumab in AO without wheals is so far demonstrated in only seven small case series reporting positive results. 43,44 However, such studies are subject to publication bias.…”

Section: Treatment Strategies and Their Limitations In Idiopathic Ang...mentioning

confidence: 99%

Treatment optimisation in chronic urticaria and angioedema

Alizadeh Aghdam

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This thesis offers new insights into the pathogenesis and management of chronic urticaria (CU), including angioedema, and suggests possibilities for a more personalized treatment approach. Using drug-survival analysis, we found that omalizumab treatment in adults and children was mainly discontinued due to well-controlled disease. Ineffectiveness or side effects are rare reasons for discontinuation, demonstrating the high effectiveness and safety of omalizumab in the treatment of CU in daily practice. In patients with a good or complete response, omalizumab treatment intervals can be extended from the standard of 4 weeks to 7 weeks (median) or longer. In patients with an insufficient treatment response to omalizumab with the standard dose of 300 mg, an increase in the dose up to 600 mg led to a significant improvement in 61% of patients. The exact pathomechanism of CU and the exact mechanism of action of omalizumab remain unknown. We found that FcεRI expression on basophils decreased significantly after omalizumab administration, while anti-IgE-induced degranulation increased significantly. Additionally, we demonstrated complement component C4d deposition in affected skin and elevated blood levels of C5a in CU patients. None of the findings regarding the complement system or FcεRI expression, however, could be related to omalizumab treatment response. Angioedema might occur, with or without wheals, and is highly manageable in the majority of patients without prophylactic therapy or with antihistamine monotherapy. Fourteen percent required add-on treatment with omalizumab or other drugs. In patients with angioedema without wheals, recombinant human C1 esterase inhibitor treatment might be a treatment option when omalizumab has failed.

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Omalizumab for treatment of idiopathic angioedema

Cited by 6 publications

References 19 publications

Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis

Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis

Omalizumab for Patients with Chronic Spontaneous Urticaria: A Narrative Review of Current Status

Treatment optimisation in chronic urticaria and angioedema

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