Omalizumab in the treatment of various forms of chronic urticaria

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Abstract

BACKGROUND: Chronic urticaria is a skin disease characterized by the appearance of itchy weals and/or angioedema for 6 or more weeks. Chronic urticaria is subdivided into chronic spontaneous urticaria, which occurs due to an unknown cause, and chronic inducible urticaria, which occurs as a result of exposure to various physical factors (water, cold, heat, pressure, mechanical irritation), can occur simultaneously or independently of each other. Omalizumab, anti-IgE monoclonal antibody, is approved for the treatment of patients with chronic spontaneous urticaria and is the second choice in cases of resistance to antihistamine treatment. In patients with a combination of chronic spontaneous urticaria and chronic inducible urticaria, the effectiveness of treatment with omalizumab has been little studied.

AIM: compare the effectiveness of omalizumab treatment in patients with chronic spontaneous urticaria and patients with a combination of chronic spontaneous and chronic induced urticaria.

MATERIALS AND METHODS: Under supervision there were 30 patients with chronic spontaneous urticaria and combined chronic spontaneous and inducible urticaria (15 patients in each group). Evaluation of the effectiveness of treatment was carried out according to the results of the questionnaires DLQI (dermatological index of quality of life), CU-Q2oL (questionnaire for quality of life in chronic urticaria), UCT (urticaria control test), UAS (urticaria activity scale), HADS (Hospital Anxiety and Depression Scale) and provocation tests in dynamics before and during treatment.

RESULTS: All patients received omalizumab 300 mg subcutaneously once a month for 6 to 12 months. After the first injection of omalizumab, we noted a decrease in the severity of urticaria, an increase in the level of disease control and quality of life when comparing parameters before and during treatment in more than 90% of patients. Improved performance remained at this level throughout all subsequent months of treatment.

CONCLUSION: Omalizumab is equally effective in patients with an isolated form of chronic spontaneous urticaria and in patients with a combined form of chronic spontaneous and inducible urticaria. The use of omalizumab allows you to control the symptoms of chronic spontaneous and inducible urticaria, even with prolonged use.

About the authors

Olga Yu. Olisova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: olisovaolga@mail.ru
ORCID iD: 0000-0003-2482-1754
SPIN-code: 2500-7989

MD, Dr. Sci. (Med.), Professor, Corresponding member of the Russian Academy of Sciences

Russian Federation, Moscow

Dayana M. Skander

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: Sk.dayana@mail.ru
ORCID iD: 0000-0002-3693-7626

Graduate Student

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Changes in the values of the scales UAS7, UCT, DLQI, CU-Q2oL during 6 to 12 months of omalizumab therapy at a dose of 300 mg once a month.

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3. Fig. 2. Patient A. (first group) diagnosed with chronic spontaneous urticaria before treatment (a) and after 6 months during treatment with omalizumab at a dose of 300 mg (b).

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4. Fig. 3. Patient A. (second group) with a diagnosis of a combined form of chronic spontaneous and chronic inducible urticaria: Evaluation of the effectiveness of treatment with an ice cube challenge before treatment (a) and 4 weeks after treatment (b).

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Copyright (c) 2023 Olisova O.Y., Skander D.M.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


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