engleski

Omalizumab in the treatment of chronic spontaneous urticaria - experience from the Clinical Hospital Center Rijeka

Introduction: Chronic spontaneous urticaria (CSU) is defined by the presence of urticaria, with or without angioedema, for a period of 6 weeks or longer without a specific cause or trigger. CSU that is refractory to antihistamines is treated with omalizumab, a recombinant monoclonal humanized antibody against human immunoglobulin E (IgE). Objective: To present our experience with the use of omalizumab in the treatment of CSU patients. Material and methods: In this retrospective study, clinical and laboratory parameters of patients with CSU treated with omalizumab in the period from February 2019 until March 2022 at the Clinical Hospital Center (CHC) Rijeka were reviewed. Disease severity was assessed using the 7-day Urticaria Activity Score (UAS7). We defined complete response (CR) as a reduction of ≥90% in baseline UAS7 or achievement of UAS7≤6 and partial response (PR) as a reduction of 30-89% from baseline UAS7. Results: In the evaluated period, a total of 18 patients received at least a single dose of omalizumab. There were 14 women and 4 men, with a median age of 57 years (range 27 - 75 years). The median baseline UAS7 score was 31 (range 28 to 40). In 10 patients (56%), urticaria was accompanied by recurrent episodes of angioedema. Total serum IgE level was elevated in 61% of patients while 50% of patients had at least one atopic comorbidity, including rhinoconjunctivitis, asthma, or history of drug allergy. There was evidence of autoimmune thyroiditis in 44% of patients. A total of 13 patients completed the first 6-month cycle of therapy, of whom one patient completed two cycles and 3 patients completed three cycles. By the end of the 1st cycle of therapy, 12 patients reached CR and 1 patient reached PR. Of the 12 patients who had complete response, 4 patients achieved CR 4 weeks after starting the treatment, but also relapsed in average 7.6 weeks after the last dose. Nevertheless, they achieved CR immediately upon retreatment. Two patients achieved long-term disease remission after only one cycle of therapy. There was no association between treatment response and laboratory parameters. No side effects were noted during treatment and follow-up. Conclusion: In our experience, omalizumab is an effective drug in the treatment of CSU, as well as in the retreatment of the relapsed disease.

chronic urticaria ; angioedema ; omalizumab

nije evidentirano