A Kessel1, E Toubi. 1. Division of Allergy and Clinical Immunology, Bnai -Zion Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Abstract
BACKGROUND: The treatment of severe chronic urticaria (CU) remains a difficult goal to achieve. Many patients do not respond to anti-histamine therapy, even when off-label doses are given. Thus, cyclosporine-A (CsA) becomes a good therapeutic option for severe patients and for some, long-term therapy is required. We evaluated the effectiveness and safety of low-dose CsA, when treatment cannot be discontinued and long-term CsA therapy is needed to maintain severe CU in remission. METHODS: Among 2000 patients with CU who were referred to our outpatient clinic, 120 patients who suffered from a very severe CU began treatment with CsA 3 mg/kg. A clinical and laboratory followup was performed during this period of treatment. RESULTS: In 20 patients, CsA was discontinued within 2-15 days after initiation because of side-effects. Among 62 of the remaining 100 patients (62%), CsA was administered for a period of 3 months with a highly beneficial outcome. In another 20 patients (20%), CsA was considered beneficial; however, it was required for a longer period of time, 5-10 years for some of the cases. In all cases, CsA was well tolerated and most important, it was safe. For 18 patients (18%), CsA therapy was reported as failed. CONCLUSION: A low dose of CsA is a good option for patients who suffer from especially severe CU. In most cases, this therapy regimen is considered effective and safe. For a small group of patients, long-term therapy is needed, and until now it is considered safe.
BACKGROUND: The treatment of severe chronic urticaria (CU) remains a difficult goal to achieve. Many patients do not respond to anti-histamine therapy, even when off-label doses are given. Thus, cyclosporine-A (CsA) becomes a good therapeutic option for severe patients and for some, long-term therapy is required. We evaluated the effectiveness and safety of low-dose CsA, when treatment cannot be discontinued and long-term CsA therapy is needed to maintain severe CU in remission. METHODS: Among 2000 patients with CU who were referred to our outpatient clinic, 120 patients who suffered from a very severe CU began treatment with CsA 3 mg/kg. A clinical and laboratory followup was performed during this period of treatment. RESULTS: In 20 patients, CsA was discontinued within 2-15 days after initiation because of side-effects. Among 62 of the remaining 100 patients (62%), CsA was administered for a period of 3 months with a highly beneficial outcome. In another 20 patients (20%), CsA was considered beneficial; however, it was required for a longer period of time, 5-10 years for some of the cases. In all cases, CsA was well tolerated and most important, it was safe. For 18 patients (18%), CsA therapy was reported as failed. CONCLUSION: A low dose of CsA is a good option for patients who suffer from especially severe CU. In most cases, this therapy regimen is considered effective and safe. For a small group of patients, long-term therapy is needed, and until now it is considered safe.
Authors: Sinisa Savic; Alexander Marsland; David McKay; Michael R Ardern-Jones; Tabi Leslie; Olivier Somenzi; Laura Baldock; Clive Grattan Journal: Allergy Asthma Clin Immunol Date: 2015-07-21 Impact factor: 3.406
Authors: Mario Sánchez-Borges; Ignacio J Ansotegui; Ilaria Baiardini; Jonathan Bernstein; Giorgio Walter Canonica; Motohiro Ebisawa; R Maximiliano Gomez; Sandra González-Diaz; Bryan Martin; Mário Morais de Almeida; Jose Antonio Ortega Martell Journal: World Allergy Organ J Date: 2021-06-03 Impact factor: 4.084
Authors: Mario Sánchez-Borges; Riccardo Asero; Ignacio J Ansotegui; Ilaria Baiardini; Jonathan A Bernstein; G Walter Canonica; Richard Gower; David A Kahn; Allen P Kaplan; Connie Katelaris; Marcus Maurer; Hae Sim Park; Paul Potter; Sarbjit Saini; Paolo Tassinari; Alberto Tedeschi; Young Min Ye; Torsten Zuberbier Journal: World Allergy Organ J Date: 2012-11 Impact factor: 4.084