The Potential Role of Omalizumab in the Treatment of Chronic Urticaria

Stitt, Jenny M.; Dreskin, Stephen C.

doi:10.2217/imt.14.31

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Omalizumab is a recombinant humanized monoclonal antibody to IgE, built through the insertion of a mouse complementarity‐determining region of monoclonal anti‐IgE onto the consensus sequence of human IgG1 . In particular, this antibody is able to bind IgE at the same epitope (CH3) as the α‐chain of FcεRI, decreasing the expression of IgE receptors with high affinity, preventing the bond between IgE and its receptor, and, therefore, not inducing the release of histamine from the IgE bound on the surface of basophils and mast cells. The bond between omalizumab and IgE decreases previously free IgE levels that, no longer free to bind FcεRI, cause a decreased expression of high‐affinity IgE receptors on mast cells and basophils .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Omalizumab is recombinant humanized monoclonal antibody to immunoglobulin E. Guidelines for the treatment of chronic idiopathic urticaria (also known as chronic spontaneous urticaria) recommend the use of omalizumab as third-line therapy in addition to high doses of histamine receptor type 1 (H ) antihistamines when they are unsuccessful as first- and second-line therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of omalizumab for the treatment of chronic idiopathic urticaria, in both controlled and real-world settings, to assess its potential role as a preferred therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer-reviewed journals in the English language, and 29 studies were included in this review. Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the drug. However, as published studies of omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio, omalizumab could become the preferred method of treatment for chronic idiopathic urticaria in patients unresponsive to H antihistamines.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Algumas questões mantêm-se em aberto em relação ao omalizumab na UCE, nomeadamente a duração ideal do tratamento, 158,164,175,181 os intervalos entre as administrações, 163 e as doses ideais para cada doente, 164 por forma a atingir o controlo completo dos sintomas. Os regimes de longa duração carecem ainda de mais investigação.…”

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Abordagem Diagnóstica e Terapêutica da Urticária Crónica Espontânea: Recomendações em Portugal

Costa

Gonçalo

Urticária³

2016

Acta Med Port

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RESUMOA urticária crónica espontânea é uma doença complexa, de etiologia mal-esclarecida, de diagnóstico fácil mas de abordagem terapêutica por vezes difícil. Tem um impacto significativo na qualidade de vida do doente e resulta em elevados custos diretos e indiretos. O diagnóstico da urticária crónica espontânea é essencialmente clínico, sendo recomendado um número limitado de exames complementares para diagnóstico diferencial e/ou para a investigação/exclusão de possível causa para a urticária crónica espontânea. Além do hemograma e da proteína C reativa, e/ou velocidade de sedimentação, os exames adicionais devem ser selecionados de acordo com critérios clínicos. O objetivo da terapêutica é o controlo clínico total da urticária crónica espontânea. A evolução deve ser documentada através do registo semanal do score de sintomas -Weekly Urticaria Activity Score (UAS7) -, assim como da avaliação de qualidade de vida. A abordagem terapêutica é baseada nos anti-histamínicos H1 (anti-H1) de segunda geração administrados de forma contínua nas doses aprovadas (primeira linha) e, na ausência de resposta clínica, até quatro vezes a dose diária aprovada (segunda linha). Os anti-H1 de primeira geração não são recomendados. Cerca de 30% dos doentes não ficam controlados com a terapêutica de segunda linha, pelo que é recomendado adicionar uma terapêutica de terceira linha. Das duas opções, omalizumab e ciclosporina, o omalizumab é a única opção com autorização de introdução no mercado para a urticária crónica espontânea, e possui melhor perfil de segurança, sendo assim recomendado preferencialmente. Em Portugal não existem recomendações nacionais aplicáveis à prática clínica. A elaboração destas recomendações é justificada pela necessidade de uniformização tanto da abordagem diagnóstica como da abordagem terapêutica dos doentes com urticária crónica espontânea em Portugal, e para a referenciação a centros especializados, nos casos mais graves.

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The prevalence of patients suffering from chronic spontaneous urticaria, in whom omalizumab cannot be stopped even after six years

Schichter-Konfino,

Mubariki,

Toubi

et al. 2024

Front. Allergy

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BackgroundOmalizumab (OMA) was the first FDA-approved biological drug for severe chronic spontaneous urticaria (CSU), and until today is the only beneficial and truly safe one. The objectives were: To assess the prevalence of CSU patients in whom OMA cannot be stopped over time. We also asked if biomarkers (e.g., anti-TPO antibodies and total IgE) could assist in anticipating this issue.MethodsWe used our prospective registry of 93 patients, which included CSU disease duration, the onset of OMA treatment, Urticaria Activity Score (UAS7) during follow-up, co-morbidities, serum IgE levels and the presence of anti-TPO antibodies. Finally, we assessed the response to OMA during a period of six years.ResultsOut of the 93 treated CSU patients, OMA was stopped in ten patients after six months being defined as failures. In another ten patients, OMA was discontinued after 2–4 years of therapy, achieving a remission. Seventy-three patients are still treated between 2 and 6 years, having different degrees of response. Of these, in thirty-eight (52%) patients, we could not stop OMA even after six years due to CSU relapses. The prevalence of lower serum IgE levels and anti-TPO antibody positivity was significantly higher in CSU patients in whom OMA could not be stopped.ConclusionThis is the first study where OMA-treated CSU patients were followed up to six years. In half of them, long-term therapy of six years is still required.

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The Potential Role of Omalizumab in the Treatment of Chronic Urticaria

Cited by 3 publications

References 31 publications

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

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

Abordagem Diagnóstica e Terapêutica da Urticária Crónica Espontânea: Recomendações em Portugal

The prevalence of patients suffering from chronic spontaneous urticaria, in whom omalizumab cannot be stopped even after six years

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