Identificação de diferentes padrões de resposta ao omalizumab em doentes com urticária crónica espontânea

Translated title of the contribution: Identification of different response patterns to omalizumab in patients with chronic spontaneous urticaria

João Marcelino, Célia Costa, Pedro Aguiar, Manuel Pereira-Barbosa

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Omalizumab is approved for severe chronic spontaneous urticaria (CSU), non-responsive to non-sedating H1‑antihistamines. However, there is little data to predict patients’ response to omalizumab. We aim to identify possible predictors of response to omalizumab in CSU patients. Methods: Retrospective chart-review study (2006‑2015), of CSU adults treated with omalizumab for 6 or more months. Statistical analyses: descriptive statistics, chi-square, odds ratio analysis and generalized linear models. Results: Twenty-three patients (3 men) were included. Prior to omalizumab, all were medicated with montelukast, quadruple daily dose of non-sedating H1-antihistamine and systemic oral corticosteroids; additionally, 15 were on H2-antihistamines. IVIg, cyclosporine and azatioprine had previously been tried in 8 patients with no efficacy. Using generalized linear models, patients showed a reduction, per omalizumab administration, of 16% (p<0.001) of the UAS (urticaria activity score) score and 20% (p<0.001) of the UAS7 (urticaria activity score 7). Women had a reduction, per omalizumab administration, of the UAS (15%, p<0.001) and UAS7 (17%, p<0.001); compared to men’s UAS (2%, p=0.067) and UAS7 (8%, p=0.067) score’s. Patients with baseline total serum IgE>500kU/L had a reduction, per omalizumab administration, of the UAS (28%, p<0.001) and UAS7 (41%, p<0.001) scores; compared to IgE<100kU/L patients who had a reduction of the UAS (12%, p<0.001) and UAS7 (20%, p<0.001) scores. Conclusions: Response to omalizumab seems to be faster in patients with higher baseline total serum IgE and in women. A lack of response to immune-modulating therapies prior to omalizumab does not predict a lack of response to omalizumab.

Original languagePortuguese
Pages (from-to)109-119
Number of pages11
JournalRevista Portuguesa de Imunoalergologia
Volume26
Issue number2
Publication statusPublished - 1 Jun 2018

Fingerprint

Urticaria
montelukast
Immunoglobulin E
Linear Models
Non-Sedating Histamine H1 Antagonists
Omalizumab
Histamine Antagonists
Cyclosporine
Adrenal Cortex Hormones
Odds Ratio

Keywords

  • Anti-IgE
  • Chronic spontaneous urticaria
  • Omalizumab
  • Total IgE
  • UAS

Cite this

@article{05476c0870b6454293b2c43243d4da53,
title = "Identifica{\cc}{\~a}o de diferentes padr{\~o}es de resposta ao omalizumab em doentes com urtic{\'a}ria cr{\'o}nica espont{\^a}nea",
abstract = "Introduction: Omalizumab is approved for severe chronic spontaneous urticaria (CSU), non-responsive to non-sedating H1‑antihistamines. However, there is little data to predict patients’ response to omalizumab. We aim to identify possible predictors of response to omalizumab in CSU patients. Methods: Retrospective chart-review study (2006‑2015), of CSU adults treated with omalizumab for 6 or more months. Statistical analyses: descriptive statistics, chi-square, odds ratio analysis and generalized linear models. Results: Twenty-three patients (3 men) were included. Prior to omalizumab, all were medicated with montelukast, quadruple daily dose of non-sedating H1-antihistamine and systemic oral corticosteroids; additionally, 15 were on H2-antihistamines. IVIg, cyclosporine and azatioprine had previously been tried in 8 patients with no efficacy. Using generalized linear models, patients showed a reduction, per omalizumab administration, of 16{\%} (p<0.001) of the UAS (urticaria activity score) score and 20{\%} (p<0.001) of the UAS7 (urticaria activity score 7). Women had a reduction, per omalizumab administration, of the UAS (15{\%}, p<0.001) and UAS7 (17{\%}, p<0.001); compared to men’s UAS (2{\%}, p=0.067) and UAS7 (8{\%}, p=0.067) score’s. Patients with baseline total serum IgE>500kU/L had a reduction, per omalizumab administration, of the UAS (28{\%}, p<0.001) and UAS7 (41{\%}, p<0.001) scores; compared to IgE<100kU/L patients who had a reduction of the UAS (12{\%}, p<0.001) and UAS7 (20{\%}, p<0.001) scores. Conclusions: Response to omalizumab seems to be faster in patients with higher baseline total serum IgE and in women. A lack of response to immune-modulating therapies prior to omalizumab does not predict a lack of response to omalizumab.",
keywords = "Anti-IgE, Chronic spontaneous urticaria, Omalizumab, Total IgE, UAS",
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Identificação de diferentes padrões de resposta ao omalizumab em doentes com urticária crónica espontânea. / Marcelino, João; Costa, Célia; Aguiar, Pedro; Pereira-Barbosa, Manuel.

In: Revista Portuguesa de Imunoalergologia, Vol. 26, No. 2, 01.06.2018, p. 109-119.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Identificação de diferentes padrões de resposta ao omalizumab em doentes com urticária crónica espontânea

AU - Marcelino, João

AU - Costa, Célia

AU - Aguiar, Pedro

AU - Pereira-Barbosa, Manuel

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Introduction: Omalizumab is approved for severe chronic spontaneous urticaria (CSU), non-responsive to non-sedating H1‑antihistamines. However, there is little data to predict patients’ response to omalizumab. We aim to identify possible predictors of response to omalizumab in CSU patients. Methods: Retrospective chart-review study (2006‑2015), of CSU adults treated with omalizumab for 6 or more months. Statistical analyses: descriptive statistics, chi-square, odds ratio analysis and generalized linear models. Results: Twenty-three patients (3 men) were included. Prior to omalizumab, all were medicated with montelukast, quadruple daily dose of non-sedating H1-antihistamine and systemic oral corticosteroids; additionally, 15 were on H2-antihistamines. IVIg, cyclosporine and azatioprine had previously been tried in 8 patients with no efficacy. Using generalized linear models, patients showed a reduction, per omalizumab administration, of 16% (p<0.001) of the UAS (urticaria activity score) score and 20% (p<0.001) of the UAS7 (urticaria activity score 7). Women had a reduction, per omalizumab administration, of the UAS (15%, p<0.001) and UAS7 (17%, p<0.001); compared to men’s UAS (2%, p=0.067) and UAS7 (8%, p=0.067) score’s. Patients with baseline total serum IgE>500kU/L had a reduction, per omalizumab administration, of the UAS (28%, p<0.001) and UAS7 (41%, p<0.001) scores; compared to IgE<100kU/L patients who had a reduction of the UAS (12%, p<0.001) and UAS7 (20%, p<0.001) scores. Conclusions: Response to omalizumab seems to be faster in patients with higher baseline total serum IgE and in women. A lack of response to immune-modulating therapies prior to omalizumab does not predict a lack of response to omalizumab.

AB - Introduction: Omalizumab is approved for severe chronic spontaneous urticaria (CSU), non-responsive to non-sedating H1‑antihistamines. However, there is little data to predict patients’ response to omalizumab. We aim to identify possible predictors of response to omalizumab in CSU patients. Methods: Retrospective chart-review study (2006‑2015), of CSU adults treated with omalizumab for 6 or more months. Statistical analyses: descriptive statistics, chi-square, odds ratio analysis and generalized linear models. Results: Twenty-three patients (3 men) were included. Prior to omalizumab, all were medicated with montelukast, quadruple daily dose of non-sedating H1-antihistamine and systemic oral corticosteroids; additionally, 15 were on H2-antihistamines. IVIg, cyclosporine and azatioprine had previously been tried in 8 patients with no efficacy. Using generalized linear models, patients showed a reduction, per omalizumab administration, of 16% (p<0.001) of the UAS (urticaria activity score) score and 20% (p<0.001) of the UAS7 (urticaria activity score 7). Women had a reduction, per omalizumab administration, of the UAS (15%, p<0.001) and UAS7 (17%, p<0.001); compared to men’s UAS (2%, p=0.067) and UAS7 (8%, p=0.067) score’s. Patients with baseline total serum IgE>500kU/L had a reduction, per omalizumab administration, of the UAS (28%, p<0.001) and UAS7 (41%, p<0.001) scores; compared to IgE<100kU/L patients who had a reduction of the UAS (12%, p<0.001) and UAS7 (20%, p<0.001) scores. Conclusions: Response to omalizumab seems to be faster in patients with higher baseline total serum IgE and in women. A lack of response to immune-modulating therapies prior to omalizumab does not predict a lack of response to omalizumab.

KW - Anti-IgE

KW - Chronic spontaneous urticaria

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KW - Total IgE

KW - UAS

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