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Retrospective analysis of the efficacy of omalizumab in chronic refractory urticaria.

Viswanathan RK, Moss MH, Mathur SK - Allergy Asthma Proc (2013 Sep-Oct)

Bottom Line: Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports.We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19).No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.

ABSTRACT
Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports. However, it remains unknown whether there are specific phenotypes of CU that are more responsive to omalizumab therapy. We sought to identify CU phenotypes responsive to treatment with omalizumab by characterizing patients and their response patterns. A retrospective chart review analysis of refractory CU patients unresponsive to high-dose H1-blockers and immunomodulators and subsequently treated with omalizumab at the University of Wisconsin Allergy Clinic was performed with particular focus on their autoimmune characteristics, response to therapy, and dosing parameters. We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19). Of these 19 patients, 9 patients (47%) had a complete response, 8 patients (42%) had a partial response, and 2 patients (11%) had no response. In comparing the response patterns to omalizumab, we found no statistically significant differences among "autoimmune positive" versus "autoimmune negative" patients. No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen. Our study shows that omalizumab has robust efficacy in refractory CU patients regardless of their autoimmune status, age, gender, IgE levels, or dosing protocol.

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Response patterns to omalizumab. The number of patients on y-axis with complete (black bar), partial (gray bar), or no (white bar) response are shown for subgroups separated based on (A) age, (B), gender, (C) IgE level, and (D) dosing protocol. The p values for statistical comparison of response patterns are shown in each panel.
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Figure 1: Response patterns to omalizumab. The number of patients on y-axis with complete (black bar), partial (gray bar), or no (white bar) response are shown for subgroups separated based on (A) age, (B), gender, (C) IgE level, and (D) dosing protocol. The p values for statistical comparison of response patterns are shown in each panel.

Mentions: Among various age groups, response patterns to omalizumab were not significantly different (p = 0.40) with 47% of subjects showing complete response, 42% showing a partial response, and 11% showing no response. The majority of patients were >18 years old, which reflects the natural predominance of CU in an older population. No differences were observed in response patterns to omalizumab between different age groups (Fig 1A). We found similar response patterns to omalizumab in male subjects (57% complete, 29% partial, and 14% none) and female subjects (42% complete, 50% partial, and 8% none) as shown in Fig. 1B. The difference in response patterns between male and female subjects did not achieve statistical significance (p = 0.81).


Retrospective analysis of the efficacy of omalizumab in chronic refractory urticaria.

Viswanathan RK, Moss MH, Mathur SK - Allergy Asthma Proc (2013 Sep-Oct)

Response patterns to omalizumab. The number of patients on y-axis with complete (black bar), partial (gray bar), or no (white bar) response are shown for subgroups separated based on (A) age, (B), gender, (C) IgE level, and (D) dosing protocol. The p values for statistical comparison of response patterns are shown in each panel.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3753597&req=5

Figure 1: Response patterns to omalizumab. The number of patients on y-axis with complete (black bar), partial (gray bar), or no (white bar) response are shown for subgroups separated based on (A) age, (B), gender, (C) IgE level, and (D) dosing protocol. The p values for statistical comparison of response patterns are shown in each panel.
Mentions: Among various age groups, response patterns to omalizumab were not significantly different (p = 0.40) with 47% of subjects showing complete response, 42% showing a partial response, and 11% showing no response. The majority of patients were >18 years old, which reflects the natural predominance of CU in an older population. No differences were observed in response patterns to omalizumab between different age groups (Fig 1A). We found similar response patterns to omalizumab in male subjects (57% complete, 29% partial, and 14% none) and female subjects (42% complete, 50% partial, and 8% none) as shown in Fig. 1B. The difference in response patterns between male and female subjects did not achieve statistical significance (p = 0.81).

Bottom Line: Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports.We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19).No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.

ABSTRACT
Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports. However, it remains unknown whether there are specific phenotypes of CU that are more responsive to omalizumab therapy. We sought to identify CU phenotypes responsive to treatment with omalizumab by characterizing patients and their response patterns. A retrospective chart review analysis of refractory CU patients unresponsive to high-dose H1-blockers and immunomodulators and subsequently treated with omalizumab at the University of Wisconsin Allergy Clinic was performed with particular focus on their autoimmune characteristics, response to therapy, and dosing parameters. We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19). Of these 19 patients, 9 patients (47%) had a complete response, 8 patients (42%) had a partial response, and 2 patients (11%) had no response. In comparing the response patterns to omalizumab, we found no statistically significant differences among "autoimmune positive" versus "autoimmune negative" patients. No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen. Our study shows that omalizumab has robust efficacy in refractory CU patients regardless of their autoimmune status, age, gender, IgE levels, or dosing protocol.

Show MeSH
Related in: MedlinePlus