Retrospective Case Note Review of Chronic Spontaneous Urticaria Outcomes and Adverse Effects in Patients Treated with Omalizumab or Ciclosporin in UK Secondary Care

Overview

Journal Allergy Asthma Clin Immunol

Specialty Allergy & Immunology

Date 2015 Jul 22

PMID 26195984

Citations 11

Authors

Sinisa Savic

Alexander Marsland

David McKay

Michael R Ardern-Jones

Tabi Leslie

Olivier Somenzi

Laura Baldock

Clive Grattan

Affiliations

Soon will be listed here.

Abstract

Background: Omalizumab is approved in the UK as add-on treatment for chronic spontaneous urticaria (CSU) in patients with inadequate response to H1-antihistamines. Ciclosporin is an established but unlicensed 3rd line option for CSU. Two parallel retrospective observational studies were conducted to describe outcomes of treatment and adverse events with omalizumab or ciclosporin for CSU treatment.

Methods: Data from UK specialist centres prescribing omalizumab (five centres) or ciclosporin (three centres) in CSU patients were collected from hospital records by clinical staff and pooled for analysis.

Results: Forty-six patients prescribed omalizumab and 72 patients prescribed ciclosporin were included. Twenty-two (48%) omalizumab-treated patients had paired Urticaria Activity Scores (UAS7), showing a 25.4 point improvement during treatment (P < 0.0001). Paired Dermatology Life Quality Index (DLQI) was available in 28 (61%) omalizumab-treated and 17 (24%) ciclosporin-treated patients. At least a 75% improvement in DLQI score was observed in 79% of omalizumab-treated and 41% of ciclosporin-treated patients, and 65% of omalizumab-treated patients had complete resolution of their quality-of-life impairment (DLQI 0-1) versus 21% of ciclosporin-treated patients. Clinician comments reported symptom clearance in 15/36 (42%) omalizumab-treated and 10/60 (17%) ciclosporin-treated patients. Proportions of patients with adverse events were similar but those for omalizumab resembled CSU symptoms, making causality assignment difficult, whereas those for ciclosporin were consistent with its known adverse effect profile.

Conclusions: Validated patient-reported measures of disease severity and quality of life should be used routinely in CSU management. Based on clinician comments and DLQI scores, symptoms and quality of life showed a greater improvement in the omalizumab-treated cohort than in the ciclosporin-treated cohort.

Citing Articles

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Current and Future Approaches in Management of Chronic Spontaneous Urticaria Using Anti-IgE Antibodies.

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Sanchez-Borges M, Ansotegui I, Baiardini I, Bernstein J, Canonica G, Ebisawa M World Allergy Organ J. 2021; 14(6):100546.

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Chen Y, Yu M, Huang X, Tu P, Shi P, Maurer M World Allergy Organ J. 2021; 14(1):100501.

PMID: 33510832 PMC: 7804987. DOI: 10.1016/j.waojou.2020.100501.

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