Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 45
Filter
1.
Chinese Journal of Dermatology ; (12): 582-585, 2021.
Article in Chinese | WPRIM | ID: wpr-911492

ABSTRACT

Objective:To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) .Methods:Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days (UAS7) and chronic urticaria quality of life (CU-Q2oL) score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results:All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point (complete control) in 93.3% of the patients, 1-6 points (favorable control) in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients (65%) achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed.Conclusion:Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.

2.
Clinical Medicine of China ; (12): 381-384, 2021.
Article in Chinese | WPRIM | ID: wpr-909762

ABSTRACT

Monoclonal antibody is a new treatment for severe asthma in children.It can selectively act on specific cytokines or pathways in the inflammatory cascade of asthma to block the inflammatory reaction, so as to reduce the number of acute attacks of asthma, reduce the dosage of drugs, and improve lung function.The main adverse reactions included injection site reaction and upper respiratory tract infection.At present, monoclonal antibodies for children include Omalizumab, Mepolizumab, Benralizumab, Reslizumab and Dupilumab.Although the efficacy of monoclonal antibody in children with asthma is obvious, its long-term effect and safety still need to be further confirmed by a large number of clinical studies.

3.
Article in Chinese | WPRIM | ID: wpr-907880

ABSTRACT

Objective:To investigate the treatment of Omalizumab for allergic asthma (AS) combined with atopic dermatitis (AD) in children.Methods:Five children who were diagnosed with moderate-to-severe AS combined with AD were admitted in the Department of Respiratory, Children′s Hospital of Nanjing Medical University from November 2018 to August 2020.All children were treated with standardized treatment of AS and Omalizumab.The efficacy and adverse reactions of Omalizumab treated for AD were observed.The scoring atopic dermatitis index (SCORAD), eczema area and severity index (EASI), the children′s dermatology life quality index (CDLQI) and numerical rating scale (NRS) were selected, the scales were used to evaluate the severity, area, itching and quality of life of AD children.Results:The AD-related evaluation indexes were remarkably decreased through the treatment of Omalizumab for 4 months, including SCORAD, EASI, CDLQI, and NRS(60.80±10.79 vs.40.30±15.62; 13.93±6.81 vs.6.18±2.70; 18.80±6.26 vs.13.20±4.82; 8.60±0.89 vs.6.00±1.87), the differences were statistically significant ( t=7.833, 4.106, 5.199, 5.099, all P<0.05). Two children administered the combination of Omalizumab and allergen specific immunotherapy, and no adverse reactions were observed in the process of immunotherapy.Totally, 104 hypodermic injections were accepted in all children, without adverse reactions being observed. Conclusions:This study suggested that the Omalizumab treatment can significantly reduce the severity and area of AD, and improve the quality of life for children with moderate-to-severe AS combined with AD.The application of Omalizumab before the allergen specific immunotherapy can improve the immunotolerance and security.There were mild adverse reactions in the treatment with the long-term hypodermic injection of Omalizumab that has higher security.Being taken together, Omalizumab is a potential novel target drug for the treatment of AD in children, and perhaps it is an adjuvant administration for allergen specific immunotherapy.

4.
Article in Chinese | WPRIM | ID: wpr-907876

ABSTRACT

Objective:To analyze the effects of the combined applications of Omalizumab and subcutaneous immunotherapy (SCIT) in improving clinical symptoms and immunotherapy tolerance in children with allergic asthma.Methods:A total of 9 children with asthma who received Omalizumab combined with SCIT in the Pediatrics Asthma Clinic of the Second Hospital of Tianjin Medical University from July 2018 to August 2020 were retrospectively analyzed.The symptoms of asthma, lung function, exhaled nitric oxide(FeNO), life quality scores, inhaled corticosteroids (ICS) dosage, comorbidities improvement, and adverse reactions during SCIT were analyzed and compared before and after the combined treatment.Results:After treatment, both the scores of children asthma control test/asthma control test (C-ACT/ACT) and pediatric asthma quality of life questionnaire (PAQLQ) improved in 9 patients with reduced or maintained doses of ICS.After treatment, comorbidities, including rhinitis and eczema, the scores of visual analogue scale (VAS) for rhinitis, pediatric rhinoconjunctivitis quality of life questionnaire(PRQLQ) and scoring atopic dermatitis (SCORAD) were all improved.During SCIT, all children didn′t have systemic adverse reactions, and 4 children had 1 (2 cases), 3 (1 case), and 8 (1 case) local adverse reactions, respectively.The number of rapid local adverse reactions accounts for only 2.6% (3/116 times), and the number of delayed local adverse reactions occupies 8.6% (10/116 times). Among them, the number of local adverse reactions accounts for only 2.6 % (3/116 times), and the dia-meters of swelling or induration were more than 4 cm.Conclusions:The combined applications of anti-IgE therapy and SCIT can effectively improve the symptoms and quality of life, and reduce asthma exacerbations and dosage of ICS in children with asthma.It also has certain effects on the improvement of comorbidities.At the same time, the addition of anti-IgE therapy can enhance the tolerance and compliance of SCIT.

5.
Article in Chinese | WPRIM | ID: wpr-907873

ABSTRACT

Objective:To investigate the therapeutic effects of Omalizumab in children suffering from multiple allergic diseases.Methods:All children who developed with multiple allergic diseases and were treated with Omalizumab in Department of Pediatrics, Peking University Third Hospital from September 2018 to December 2020 were retrospectively analyzed.Their gender, age, type of allergic disease, serum total IgE (TIgE) and serum allergen-specific IgE (sIgE) levels before treatment, Omalizumab dosage, therapeutic effect and adverse drug reactions were analyzed.Results:In terms of the 28 children who were treated with Omalizumab, the male/female ratio was 17/11, and the age was (9.6±2.7)years.There were 24 cases of asthma (85.7%), 24 cases of allergic rhinitis (85.7%), 9 cases of food allergy (32.1%), 7 cases of atopic dermatitis (25.0%), and 2 cases of chronic urticaria (7.1%), with 26 cases (92.8%) having more than two kinds of allergic diseases, and 28 children having elevated TIgE or sIgE.TIgE was between 39.5 to 3 826.0 kU/L, and the median was 611 kU/L.After treatment, the frequency of wheezing attacks in 24 children with asthma was reduced, the nasal symptoms in 24 children with allergic rhinitis were alleviated, the skin it-ching in 6 children with atopic dermatitis was alleviated, and 1 case had poor improvement, the symptoms in 2 cases with chronic urticaria were alleviated, 9 children had food allergy and 3 cases reached tolerance.Conclusions:The treatment of allergic diseases in children, apart from asthma, Omalizumab is suitable for allergic rhinitis, atopic dermatitis and chronic urticaria.In the treatment of food allergy, it also has the function of increasing the threshold of food allergen tolerance.There are significant therapeutic benefits in children with multiple allergic diseases or being allergic to multiple allergens.

6.
Article in Chinese | WPRIM | ID: wpr-907300

ABSTRACT

Allergic diseases which affect children′s health and quality of life are common diseases.Many pediatric patients′ symptoms are uncontroled after routine treatments.Omalizumab, a highly specific and binding humanized monoclonal anti-IgE antibody, has been approved as an additional treatment for moderate to severe persistent asthma and chronic spontaneous urticaria now.At the same time, there are also data confirming its efficacy and safety in other allergic diseases.This review mainly summarizes the application of omalizumab in children with allergic diseases, and focuses on the evaluation system of clinical efficacy in various diseases.Meanwhile, it discusses how the potential biomarkers predict and evaluate clinical reactions.

7.
Semina cienc. biol. saude ; 41(2, Supl.): 321-330, jun./dez. 2020. Tab
Article in Portuguese | LILACS | ID: biblio-1247504

ABSTRACT

Introdução: a asma é uma doença heterogênea, caracterizada por inflamação crônica das vias aéreas inferiores, associada a diferentes fenótipos. O omalizumabe é utilizado em adição ao tratamento quando não se obtém o controle adequado da asma. Este estudo mostra o perfil epidemiológico e a adesão ao tratamento dos pacientes acompanhados no Ambulatório de Especialidades do Hospital Universitário da Universidade Estadual de Londrina (AEHU-UEL) em uso de omalizumabe em um período de 12 meses. Método: realizado um estudo transversal retrospectivo através de dados secundários de prontuário avaliando pacientes com diagnóstico de asma alérgica grave em uso de omalizumabe nos 12 meses prévios ao recrutamento. Resultados: foram selecionados 40 pacientes que preencheram os critérios de inclusão. A média de idade foi de 51,4 anos, com predomínio de mulheres (70%), brancos (48%), não tabagistas (90%), com sobrepeso ou obesidade (75%) e diagnóstico de asma na infância (45%). O tempo médio de tratamento foi de 8,1 anos (DP 0,8). Havia comorbidades em 85% dos pacientes, com predomínio de rinite (62,5%) e DRGE (40%). Houve exacerbação em 29 pacientes levando a 8 internações (27,5%); 93% dos exacerbadores apresentaram faltas. Conclusão: a amostra é comparável a outros estudos de vida real nos achados epidemiológicos (idade, sexo, fenótipo, tempo de diagnóstico, controle da doença e tabagismo). O elevado número de faltas, assim como frequência de DRGE e outras comorbidades e a baixa adesão à terapêutica, podem justificar o elevado número de exacerbações e maior dificuldade de controle.(AU)


Introduction: asthma is a hetereogeneous disease, characterized by chronic inflammation of the lower airways associated with different phenotypes. Omalizumab is used in addition to treatment when adequate asthma control is not achieved. This study shows the epidemiological profile and the adherence to the treatment of patients followed at the Medical Clinic of the State University Hospital of Londrina (AEHU-UEL) using omalizumab in the last 12 months. Methods: severe allergic asthma patients using omalizumab in the last 12 months were evaluated by means of secondary medical records. Results: forty patients were included and had complete medical record. The average age was 51.4 years mostly women (70%), white (48%), non-smoker (90%), overweight or obese (75%) and childhood asthma diagnosis (45%). The average treatment time was 8.1 years (SD0.8). There were co-morbidities in 85% of the patients, mainly rhinitis in 62.5% and GERD in 40%. There were exacerbations in 29 patients, leading to 8 hospitalizations (27.5%), 93% of exacerbators was missed at least one time. Strong association with rhinitis (p=0.07), and no disease control (p=0.22). Conclusion: the sample is comparable to other real-life studies in almost all epidemiological findings (age, sex, phenotype, time of diagnosis, disease control and smoking). The high number of absences and frequency of GERD and other comorbidities, and poor adhesion, may justify the high number of exacerbations and more difficulty to control the disease. (AU)


Subject(s)
Humans , Asthma , Disease , Omalizumab , Phenotype , Association , Diagnosis , Control , Hospitalization , Inflammation
8.
Article | IMSEAR | ID: sea-213986

ABSTRACT

Background:In this study, we aimed to evaluate the response of patient treated with omalizumab at certain time intervals through 6 months with pruritus visual analog scale, urticaria activity score and quality of life indexes. Methods:The study was performed on ten patients diagnosed with chronic idiopathic spontaneous urticaria.The disease was assessed by the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and Dermatology Life Quality Index(DLQI) for every 2 weeks while was assessed by Urticaria Activity Score (UAS-7) and Pruritus Visual Analog Scale (PVAS) for once a week during the 6-month treatment period.Statistical significance was evaluated using the Mann-WhitneyUtest in SPSS 20.Results:Pre-treatment values of the DLQI, CU-Q2oL, UAS-7, and PVAS was statistically higher than post-treatment values of these indexes (p<0.05). The mean DLQI/ CU-Q2oLvalue of the patients beforetreatment was 17±6.09/ 52.87±22.07 while it was 19.4±16.36 at the end of 2nd-week post-injection per month, and was 21.85±16.56 at the end of 4nd-week post-injection per month during 6-months following. Statistically, PVAS score at the 4thweek was higher than 2nd and 3rdweeks(p<0.042, p<0.007).Conclusions:In this study, it was detected that omalizumab had a significant effect on DLQI, CU-Q2oL, UAS-7, PVAS scores in CISU. It can be concluded that significant increase of PVAS score at 4th week compared to scores at 2nd and 3rd week may necessitate the use of omalizumab combined with antihistamines at 4th week of the treatment

9.
Article | IMSEAR | ID: sea-205266

ABSTRACT

Introduction: Immunoglobulin E dependent mechanisms play an important role in the development of airway inflammation in allergic asthma. Atopic patients with severe asthma frequently have poorly controlled disease. Many have poor asthma control despite intensive treatment. Severe allergic asthma patients frequently treated with oral corticosteroids and therefore may develop serious side-effects. Anti-IgE antibody had been used in severe persistent allergic asthma in Western countries. However, its long-term efficacy in patients in India has not been reported. Objective: To assess the efficacy of anti IgE therapy in patients with severe allergic asthma. Method: 30 (16 male and 14 female) patients, with mean age of 49 having severe persistent allergic asthma, with recurrent exacerbations and on oral/IV steroids, received Omalizumab 150mg/300mg/450 mg for 1 year. Total dose of oral Steroids, use of rescue medications, changes in lung function (FEV1) were recorded at the baseline, 16 weeks & at end of the treatment (52 weeks) and then analyzed. Results: Significant reduction observed in total oral steroid use at 16 week & at 52 weeks. -10.5mg (p<0.003) & 22.5mg respectively. Use of rescue medications decreased by -7.90 puffs(p- <0.001) at 16 weeks and by -13.67 puffs (13.67 (p -<0.001) at 52 weeks. Improvements in lung Function (FEV1) observed with a tune of 700 ml. from Baseline after 52 weeks therapy. Conclusion: Use of anti-IgE antibody for 1 year is well tolerated and led to an overall significant improvement in patients with severe persistent allergic asthma.

10.
Med. interna Méx ; 35(2): 298-301, mar.-abr. 2019. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1135177

ABSTRACT

Resumen: El término asma/EPOC, denominado SOAE (sobreposición asma/EPOC), incluye a un subconjunto de pacientes con persistencia y limitación del flujo aéreo con características clínicas de asma y de EPOC. La falta de consenso de una definición de sobreposición asma/EPOC ha llevado a la amplia gama en prevalencia que varía entre 11 y 56% en la EPOC, 13 y 61% en el asma y 2% entre la población general. Los estudios iniciales han demostrado que omalizumab puede ser útil en pacientes con sobreposición asma/EPOC porque ha demostrado aliviar los síntomas, reducir las exacerbaciones y la hospitalización, así como mejorar los parámetros de función pulmonar y disminuir el requerimiento de esteroides en estos pacientes. Este artículo describe el efecto de omalizumab en cinco pacientes con diagnóstico de síndrome de sobreposición asma/EPOC y administración de omalizumab. Se describe la experiencia de nuestro centro y los beneficios que el tratamiento ha dado a nuestros pacientes, que han permitido mejor calidad de vida y disminuir de manera radical su morbilidad.


Abstract The term asthma/COPD, called SOAE (overlap asthma/EPOC acronym in English ACOS [asthma COPD overlap syndrome]), includes a subset of patients with persistence and airflow limitation that presents clinical features of both asthma and COPD. Lack of consensus on a definition of ACOS has led to the wide range in prevalence ranging between 11 and 56% in COPD, 13 and 61% in asthma, and 2% in the general population. The initial studies have shown that omalizumab may be useful in patients with ACOS, it has been shown to improve symptoms, reduce exacerbations and hospitalization, as well as improve lung function parameters and reduce steroid requirement in these patients. This paper describes the effect of omalizumab in 5 patients with a diagnosis of overlying asthma/COPD syndrome (SOAE) and administration of omalizumab. We describe the experience of our center and the benefits that the treatment has given to our patients. These benefits have allowed the patient a better quality of life and radically reduce their morbidity.

11.
An. bras. dermatol ; 94(2,supl.1): 56-66, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011090

ABSTRACT

Abstract: Background: Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives: To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods: A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results: Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions: Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.


Subject(s)
Humans , Adult , Urticaria/diagnosis , Urticaria/drug therapy , Consensus , Societies, Medical , Urticaria/prevention & control , Severity of Illness Index , Brazil , Chronic Disease , Anti-Allergic Agents/therapeutic use , Cyclosporins/therapeutic use , Histamine H1 Antagonists, Non-Sedating/therapeutic use , Dermatology , Omalizumab/therapeutic use , Immunosuppressive Agents/therapeutic use
12.
Arch. argent. pediatr ; 117(2): 115-120, abr. 2019. graf, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1001167

ABSTRACT

El anticuerpo monoclonal anti-IgE omalizumab está indicado para tratamiento del asma grave. Estudio longitudinal (pre-posintervención), observacional y analítico con el objetivo de evaluar la evolución clínica y funcional de pacientes con asma grave no controlada, 16 semanas antes y después del tratamiento. En los 17 casos, se controló el asma (p= 0,00001). Se redujeron en un 48,5 % las exacerbaciones (p= 0,009) y en un 100 % las crisis graves (p= 0,001). Dieciséis pacientes (el 94 %) tuvieron exacerbaciones pretratamiento y 10 (el 59 %), luego del omalizumab (p= 0,005). No hubo hospitalizaciones (p= 0,007). Se redujo en un 20 % la dosis de corticoides inhalados (0,002) y el número de casos con corticoides orales continuos (p= 0,01); disminuyó el uso de salbutamol (p= 0,001) y de corticoides orales (p= 0,003). No se modificó la función pulmonar. Dos casos presentaron reacciones adversas leves. El omalizumab permitió un adecuado control de la enfermedad en pacientes con asma grave.


Omalizumab, an anti-IgE monoclonal antibody, is indicated for the treatment of severe asthma. A longitudinal (pre-/post-intervention), observational, analytical study was conducted to assess the clinical and functional course of patients with uncontrolled severe asthma, 16 weeks before and after treatment. Asthma was controlled in 17 cases (p = 0.00001). Exacerbations were reduced by 48.5 % (p = 0.009) and severe crises, by 100 % (p = 0.001). Before omalizumab treatment, 16 patients (94 %) had exacerbations, whereas 10 (59 %) had them after treatment (p = 0.005). None of the patients was hospitalized (p = 0.007). The dose of inhaled corticosteroids was reduced by 20 % (0.002); the number of patients using continuous oral corticosteroids (p = 0.01), salbutamol (p = 0.001), and oral corticosteroids (p=0.003) also decreased. Pulmonary function was not affected. Two patients had mild adverse reactions. Omalizumab achieved an adequate asthma control in patients with severe asthma.


Subject(s)
Humans , Child , Asthma , Child , Omalizumab
13.
Chinese Journal of Dermatology ; (12): 652-655, 2019.
Article in Chinese | WPRIM | ID: wpr-797851

ABSTRACT

Chronic spontaneous urticaria (CSU) is characterized by recurrent wheals with severe itching, and greatly affects the life quality of patients. The European guideline on chronic urticaria recommends the anti-IgE monoclonal antibody omalizumab as the only third-line therapy for patients with CSU whose condition can not be controlled by high doses of antihistamines. Although a lot of researches have shown that omalizumab is effective and safe for the treatment of CSU, its therapeutic mechanisms have not yet been fully elucidated. This review summarizes therapeutic mechanisms of omalizumab in the treatment of CSU, and indices for predicting and monitoring its clinical efficacy.

14.
Chinese Journal of Dermatology ; (12): 652-655, 2019.
Article in Chinese | WPRIM | ID: wpr-755824

ABSTRACT

Chronic spontaneous urticaria (CSU) is characterized by recurrent wheals with severe itching,and greatly affects the life quality of patients.The European guideline on chronic urticaria recommends the anti-IgE monoclonal antibody omalizumab as the only third-line therapy for patients with CSU whose condition can not be controlled by high doses of antihistamines.Although a lot of researches have shown that omalizumab is effective and safe for the treatment of CSU,its therapeutic mechanisms have not yet been fully elucidated.This review summarizes therapeutic mechanisms of omalizumab in the treatment of CSU,and indices for predicting and monitoring its clinical efficacy.

15.
Asia Pacific Allergy ; (4): e7-2019.
Article in English | WPRIM | ID: wpr-750167

ABSTRACT

Childhood asthma is one condition within a family of allergic diseases, which includes allergic rhinitis, atopic dermatitis, and food allergy, among others. Omalizumab is an anti-IgE antibody therapy that was approved in Japan for children with asthma and added to the Japanese pediatric asthma guidelines in 2017. This review highlights the Japanese clinical perspectives in pediatric allergic asthma, and consideration for allergic comorbidities, and reflects on omalizumab clinical trials in progress to present comprehensive future opportunities.


Subject(s)
Asian Continental Ancestry Group , Asthma , Child , Comorbidity , Dermatitis, Atopic , Food Hypersensitivity , Humans , Japan , Omalizumab , Rhinitis, Allergic
16.
Article in Korean | WPRIM | ID: wpr-766542

ABSTRACT

Chronic spontaneous urticaria (CSU), also known as chronic idiopathic urticaria, is a common chronic inflammatory skin disorder that has a prevalence of 0.5% to 1% in the general population. It affects daily normal life and work productivity, with significant impacts on quality of life. Generally, the management of CSU uses a step-wise approach. Although second-generation H1 antihistamines are an effective mainstay of CSU, approximately 20% of patients are resistant to conventional antihistamine monotherapy. Evidence-based and expert consensus-based treatment guidelines of CSU can be a useful resource for primary care physicians and specialists. This review presents diverse information to support decision-making for individualized treatment plans in this special population. Several major therapeutic advances have occurred in recent years. Omalizumab, an immunoglobulin G humanized monoclonal anti-immunoglobulin E antibody that prevents binding of immunoglobulin E to the high-affinity immunoglobulin E receptor has shown safety and efficacy in patients with intractable CSU. In well-controlled clinical trials in patients with refractory CSU who received add-on therapy with subcutaneous omalizumab (300 mg every 4 weeks for 12 or 24 weeks), the rates of complete response were significantly higher in the omalizumab group (relative risk, 4.55; P < 0.0001). The introduction of omalizumab as an add-on therapy to H1 antihistamines as a management option has markedly improved the therapeutic possibilities for CSU and the quality of life of CSU patients. Nevertheless, many patients still do not tolerate or benefit from existing therapies, including omalizumab. There are ongoing studies investigating the treatment potential of novel therapeutic targets in CSU.


Subject(s)
Efficiency , Histamine Antagonists , Humans , Immunoglobulin E , Immunoglobulin G , Immunoglobulins , Omalizumab , Physicians, Primary Care , Prevalence , Quality of Life , Receptors, IgE , Skin , Specialization , Urticaria
17.
Article in Chinese | WPRIM | ID: wpr-734744

ABSTRACT

Chronic spontaneous urticaria is defined as recurrent wheals of unknown etiology for more than 6 weeks,with or without angioneurotic edema.The key step in the pathogenesis of chronic spontaneous urticaria is activation and degranulation of mast cells and basophils.Omalizumab,a recombinant humanized IgG monoclonal antibody,can selectively bond the Fc region of free IgE antibodies,and then block IgE-FCeR Ⅰ-mediated activation of mast cells and basophils.Three phase Ⅲ clinical trials have been reported on the efficacy of omalizumab in the treatment of chronic spontaneous urticaria,which confirm the efficacy and safety of omalizumab in the treatment of refractory chronic spontaneous urticaria.

18.
Med. interna Méx ; 34(6): 833-839, nov.-dic. 2018. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-990153

ABSTRACT

Resumen: OBJETIVO Determinar la mejoría clínica en los pacientes con diagnóstico de asma moderada a severa no atópica en tratamiento con omalizumab. MATERIAL Y MÉTODO estudio prospectivo y observacional en el que del 1 de enero de 2017 al 1 de enero de 2018 se incluyeron pacientes adultos que, a pesar del tratamiento diario con o sin mantenimiento con corticoesteroides orales, tenían asma moderada a severa no atópica descontrolada; los pacientes se asignaron a recibir omalizumab por concentraciones de IgE. El punto final primario fue el cambio en los parámetros clínicos y funcionales de los pacientes por medio de examen de la prueba ACT (Asthma Control Test). RESULTADOS Se incluyeron 20 pacientes. Tras 52 semanas de administración de omalizumab los pacientes mostraron aumento moderado en el FEV1 y mejoría de los parámetros clínicos y funcionales. El alivio sintomático de los pacientes se consideró principalmente con el aumento en la prueba ACT de 10 a 20 puntos. También se observó buena tolerancia al medicamento, sin ningún efecto adverso grave y mejoría en la calidad de vida de los pacientes. CONCLUSIONES Omalizumab tiene un papel terapéutico en el asma no atópica moderada a severa. Nuestros resultados apoyan la eficacia clínica de omalizumab en los pacientes asmáticos no atópicos mexicanos.


Abstract: OBJECTIVE To determine the clinical improvement in patients diagnosed with moderate-severe non-atopic asthma in treatment with omalizumab. MATERIAL AND METHOD A prospective and observational study was made from January 1st 2017 to January 1st 2018 in adult patients who, despite daily treatment with or without maintenance oral corticosteroids, had uncontrolled moderate to severe non-atopic asthma; patients were assigned to receive omalizumab at doses of IgE levels. The primary endpoint was the change in the clinical and functional parameters of the patients by means of Asthma Control Test. RESULTS There were included 20 patients. After 52 weeks of administration of omalizumab they showed a moderate increase in FEV1 and in clinical and functional parameters. The symptomatic improvement of the patients was mainly considered by an increase of 10 to 20 points in Asthma Control Test. Good tolerance to the drug was also observed, without any serious adverse effects, as well as improvement in the quality of life of the patients. CONCLUSIONS Omalizumab has a therapeutic role in moderate to severe non-atopic asthma. Our results support the clinical efficacy of omalizumab in Mexican non-atopic asthmatic patients.

19.
Asia Pacific Allergy ; (4): e2-2018.
Article in English | WPRIM | ID: wpr-750131

ABSTRACT

Bee venom immunotherapy (b-VIT) can be combined with omalizumab therapy in order to suppress systemic reactions developing due to b-VIT itself. Omalizumab acts as a premedication and gains time for the immunotherapy to develop its immunomodulatory effects. However, the combination of omalizumab and b-VIT is not always effective enough. Herein we present a patient in whom successful immunotherapy cannot be achieved with combination of omalizumab to b-VIT.


Subject(s)
Anaphylaxis , Bee Venoms , Bees , Humans , Immunotherapy , Omalizumab , Premedication
20.
Article in Korean | WPRIM | ID: wpr-741108

ABSTRACT

Mastocytosis is a disorder characterized by abnormal mast cell proliferation and accumulation in one or more tissues. It presents in two major variants: cutaneous mastocytosis and systemic mastocytosis. Because the symptoms are related to mast cells, histamine receptor antagonists and leukotriene receptor antagonists are recommended as therapeutic options. Here, we report a 54-year-old male patient with a history of urticaria pigmentosa who presented with recurrent anaphylaxis. His serum tryptase level was 31.7 ng/mL and mast cell infiltration was observed in his bone marrow. He had frequent attacks of anaphylaxis despite treatment with ketotifen, levocetirizine, and montelukast. Symptoms related to systemic mastocytosis were controlled and the patient exhibited no recurrence of anaphylaxis following the introduction of monthly omalizumab injection. Omalizumab can be considered as a treatment option in patients with systemic mastocytosis unresponsive to conventional oral medications.


Subject(s)
Anaphylaxis , Bone Marrow , Humans , Ketotifen , Leukotriene Antagonists , Male , Mast Cells , Mastocytosis , Mastocytosis, Cutaneous , Mastocytosis, Systemic , Middle Aged , Omalizumab , Receptors, Histamine , Recurrence , Tryptases , Urticaria Pigmentosa
SELECTION OF CITATIONS
SEARCH DETAIL