Daniel Har1, Saurin Patel2, David A Khan2. 1. University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: Daniel.Har@Phhs.org. 2. University of Texas Southwestern Medical Center, Dallas, Texas.
Abstract
BACKGROUND: Because omalizumab was only recently approved for refractory chronic urticaria (CU), there are few studies that have evaluated patients using omalizumab for longer than 1 year. OBJECTIVE: To evaluate omalizumab's effectiveness, its feasibility in weaning, and its safety profile in patients with refractory CU who were on omalizumab for longer than 1 year. METHODS: A retrospective chart review was conducted of adults with well-defined refractory CU in the authors' clinic from October 2005 to January 2015 who responded to omalizumab and who had taken it for longer than 1 year. In addition to baseline characteristics, the duration, course, and adverse effects of omalizumab therapy were analyzed. RESULTS: Eight of 10 patients had complete resolution of symptoms after reaching their optimal regimen and had taken omalizumab for a median duration of 37 months (17-112 months). None of them required uptitration of dosage, an increase in frequency of dosage, or add-on therapy. Five of 8 patients, while being tapered, had recurrence of symptoms requiring the reuse of omalizumab. One successfully discontinued omalizumab, 1 was in the process of being weaned but did not experience a flare, and 1 had not attempted weaning. CONCLUSION: This study from the United States suggests that omalizumab is effective and safe in patients with refractory CU who use omalizumab for longer than 1 year. Periodic attempts at weaning patients with CU from omalizumab should be attempted because there could be a chance of spontaneous remission. This might be difficult because symptoms are likely to recur, but restarting omalizumab in these patients seems effective and safe.
BACKGROUND: Because omalizumab was only recently approved for refractory chronic urticaria (CU), there are few studies that have evaluated patients using omalizumab for longer than 1 year. OBJECTIVE: To evaluate omalizumab's effectiveness, its feasibility in weaning, and its safety profile in patients with refractory CU who were on omalizumab for longer than 1 year. METHODS: A retrospective chart review was conducted of adults with well-defined refractory CU in the authors' clinic from October 2005 to January 2015 who responded to omalizumab and who had taken it for longer than 1 year. In addition to baseline characteristics, the duration, course, and adverse effects of omalizumab therapy were analyzed. RESULTS: Eight of 10 patients had complete resolution of symptoms after reaching their optimal regimen and had taken omalizumab for a median duration of 37 months (17-112 months). None of them required uptitration of dosage, an increase in frequency of dosage, or add-on therapy. Five of 8 patients, while being tapered, had recurrence of symptoms requiring the reuse of omalizumab. One successfully discontinued omalizumab, 1 was in the process of being weaned but did not experience a flare, and 1 had not attempted weaning. CONCLUSION: This study from the United States suggests that omalizumab is effective and safe in patients with refractory CU who use omalizumab for longer than 1 year. Periodic attempts at weaning patients with CU from omalizumab should be attempted because there could be a chance of spontaneous remission. This might be difficult because symptoms are likely to recur, but restarting omalizumab in these patients seems effective and safe.
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: Coco Dekkers; Mehran Alizadeh Aghdam; Marlies de Graaf; André C Knulst; Yolanda Meijer; Juul M P A van den Reek; Marike B Stadermann; Heike Röckmann Journal: Pediatr Allergy Immunol Date: 2021-01-18 Impact factor: 6.377
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