Gordon Sussman1, Jacques Hébert2, Carly Barron3, Jia Bian3, Rose-Marie Caron-Guay2, Stéphanie Laflamme2, Simon Stern3. 1. Division of Allergy and Clinical Immunology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: gsussman@rogers.com. 2. Centre de recherche appliquée en allergie de Québec, Laval University, Quebec City, Quebec, Canada. 3. Division of Allergy and Clinical Immunology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Evidence has shown that omalizumab, a subcutaneous anti-IgE monoclonal antibody, is highly effective for the treatment of chronic urticaria. OBJECTIVE: To evaluate omalizumab 150 mg/month in severe, difficult-to-treat, chronic urticaria in a real-life setting. METHODS: This prospective open-label study evaluated of 150 mg of omalizumab in severe urticaria defined by a 7-day urticaria activity score (UAS-7) higher than 30, a history of oral glucocorticoid use, and by suboptimal response to previous treatments. Two subgroups of patients at different centers (Toronto and Quebec City, Canada) were included. The primary efficacy evaluation was a change in UAS-7 from baseline. A quantitative medication score assessed the use of other anti-urticarial medications. RESULTS: Sixty-eight patients were included: 61 with chronic spontaneous urticaria, 6 with cold urticaria, and 1 with urticarial vasculitis. Patients were followed for up to 25 months. In Toronto, mean UAS-7 decreased from 32.2 at baseline to 5.7 after the last omalizumab treatment. Seventy-nine percent achieved complete remission during omalizumab therapy (UAS-7 0) and 6 (18%) showed improvement but never achieved complete remission. The most common maintenance dosing intervals were 1 to 3 months. In Quebec City, from baseline to 18 months, mean UAS-7 decreased from 24.4 to 2.2 and the quantitative medication score decreased from 13.3 to 3.0. All 6 patients with cold urticaria became symptom free, with a significant decrease of their cold stimulation tolerance test. CONCLUSION: Omalizumab 150 mg was effective in difficult to treat patients with severe, chronic urticaria refractory to recommended treatments who usually required prednisone. Omalizumab induced a long-lasting positive response and was well tolerated without side effects.
BACKGROUND: Evidence has shown that omalizumab, a subcutaneous anti-IgE monoclonal antibody, is highly effective for the treatment of chronic urticaria. OBJECTIVE: To evaluate omalizumab 150 mg/month in severe, difficult-to-treat, chronic urticaria in a real-life setting. METHODS: This prospective open-label study evaluated of 150 mg of omalizumab in severe urticaria defined by a 7-day urticaria activity score (UAS-7) higher than 30, a history of oral glucocorticoid use, and by suboptimal response to previous treatments. Two subgroups of patients at different centers (Toronto and Quebec City, Canada) were included. The primary efficacy evaluation was a change in UAS-7 from baseline. A quantitative medication score assessed the use of other anti-urticarial medications. RESULTS: Sixty-eight patients were included: 61 with chronic spontaneous urticaria, 6 with cold urticaria, and 1 with urticarial vasculitis. Patients were followed for up to 25 months. In Toronto, mean UAS-7 decreased from 32.2 at baseline to 5.7 after the last omalizumab treatment. Seventy-nine percent achieved complete remission during omalizumab therapy (UAS-7 0) and 6 (18%) showed improvement but never achieved complete remission. The most common maintenance dosing intervals were 1 to 3 months. In Quebec City, from baseline to 18 months, mean UAS-7 decreased from 24.4 to 2.2 and the quantitative medication score decreased from 13.3 to 3.0. All 6 patients with cold urticaria became symptom free, with a significant decrease of their cold stimulation tolerance test. CONCLUSION:Omalizumab 150 mg was effective in difficult to treat patients with severe, chronic urticaria refractory to recommended treatments who usually required prednisone. Omalizumab induced a long-lasting positive response and was well tolerated without side effects.
Authors: Michael D Tharp; Jonathan A Bernstein; Abhishek Kavati; Benjamin Ortiz; Karen MacDonald; Kris Denhaerynck; Ivo Abraham; Christopher S Lee Journal: JAMA Dermatol Date: 2019-01-01 Impact factor: 10.282
Authors: Gordon Sussman; Jacques Hébert; Wayne Gulliver; Charles Lynde; Susan Waserman; Amin Kanani; Moshe Ben-Shoshan; Spencer Horemans; Carly Barron; Stephen Betschel; William H Yang; Jan Dutz; Neil Shear; Gina Lacuesta; Peter Vadas; Kenneth Kobayashi; Hermenio Lima; F Estelle R Simons Journal: Allergy Asthma Clin Immunol Date: 2015-02-11 Impact factor: 3.406