Omalizumab for Cyclosporine-resistant Chronic Spontaneous Urticaria:A Retrospective Study of a Single Center
- Author:
Hak-Jun KIM
1
;
Woo-il KIM
;
Kihyuk SHIN
;
Jin-Hwa SON
;
Won-Ku LEE
;
Hoon-Soo KIM
;
Byungsoo KIM
;
Moon-Bum KIM
;
Hyun-Chang KO
Author Information
1. Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Publication Type:Original Article
- From:Korean Journal of Dermatology
2021;59(3):175-180
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Cyclosporine is a recommended third-line treatment for chronic spontaneous urticaria (CSU) that is resistant to H1-antihistamines according to the EAACI/GA 2 LEN/EDF/WAO guidelines for management of urticaria. However, some patients with refractory urticaria do not respond to cyclosporine or antihistamines. Omalizumab, a humanized anti-immunoglobulin E antibody, has been shown to be effective and safe for antihistamine-resistant CSU. However, there are few reports on the efficacy of omalizumab in patients with CSU who are resistant to cyclosporine.
Objective:To evaluate the efficacy of omalizumab in patients with cyclosporine-resistant CSU.
Methods:Recalcitrant CSU patients who had symptoms (seven-day urticaria activity score, UAS7≥7) despite being administered cyclosporine (3∼5 mg/kg/day) and H1-antihistamine at up to a four-fold increased dose for 4 weeks were included in this study. Omalizumab was administered at 150 mg or 300 mg by subcutaneous injection every 4 weeks. Efficacy was assessed using UAS7 12 weeks after the initial administration of omalizumab.
Results:A total of 28 patients (18 women, 10 men) with an average age of 43.8 years were included in the study. The mean duration of CSU was 40.0 (2∼288) months, and the mean UAS7 at baseline was 14.2 (9∼35) months. Overall, 22 patients (78.6%) showed a complete (UAS7=0) or partial response (0＜UAS7≤6) at 12 weeks. Patients who were administered 300 mg of omalizumab had a more complete response (9/15, 60%) than those who were treated with 150 mg (3/13, 23.1%).
Conclusion:Omalizumab is an effective therapy for CSU patients who do not respond to cyclosporine.
