[Anti-IgE-directed Treatment of Urticaria in A dermatological Practice]

Overview

Journal Dermatologie (Heidelb)

Specialty Dermatology

Date 2022 Aug 4

PMID 35925212

Authors

Evangelia Diamanti

Julia Fohr

Andria Papageorgiou

Matthias Herbst

Sigbert Jahn

Affiliations

Soon will be listed here.

Abstract

We conducted a retrospective data analysis of 26 patients with chronic spontaneous urticaria (CSU), 12 of whom had been treated with anti-IgE therapy (omalizumab). The subcohort of patients treated with omalizumab displayed more severe and prolonged courses of disease. In addition, they had often undergone various inpatient therapies, frequently presenting with concomitant angioedema. Collecting the Urticaria Activity Scores from the seven daily values for wheals and itching (UAS7) proved an important and suitable instrument for the determination and assessment of the course of therapy in the dermatological office. Elaborate laboratory screenings, however, seem far less indicative of the severity, prognosis and course of the disease. Omalizumab proved to be a viable and well-tolerated treatment option. One third of the patients were completely free of all symptoms, another third showed very good improvement, whereas the last third showed no improvement at all, even when omalizumab and/or concomitant therapies were escalated.

References

Eggel A, Baravalle G, Hobi G, Kim B, Buschor P, Forrer P . Accelerated dissociation of IgE-FcεRI complexes by disruptive inhibitors actively desensitizes allergic effector cells. J Allergy Clin Immunol. 2014; 133(6):1709-19.e8. PMC: 4083100. DOI: 10.1016/j.jaci.2014.02.005. View

Ferrer M, Bartra J, Gimenez-Arnau A, Jauregui I, Labrador-Horrillo M, Ortiz de Frutos J . Management of urticaria: not too complicated, not too simple. Clin Exp Allergy. 2014; 45(4):731-43. PMC: 4403957. DOI: 10.1111/cea.12465. View

Gonzalez-Diaz S, Sanchez-Borges M, Rangel-Gonzalez D, Guzman-Avilan R, Canseco-Villarreal J, Arias-Cruz A . Chronic urticaria and thyroid pathology. World Allergy Organ J. 2020; 13(3):100101. PMC: 7063156. DOI: 10.1016/j.waojou.2020.100101. View

Bauer A, Dickel H, Jakob T, Kleinheinz A, Lippert U, Metz M . . Allergo J. 2021; 30(2):40-55. PMC: 7994058. DOI: 10.1007/s15007-021-4772-2. View

Radonjic-Hoesli S, Scherer Hofmeier K, Micaletto S, Schmid-Grendelmeier P, Bircher A, Simon D . Urticaria and Angioedema: an Update on Classification and Pathogenesis. Clin Rev Allergy Immunol. 2017; 54(1):88-101. DOI: 10.1007/s12016-017-8628-1. View

Fohr J, Herbst M, Jahn S . [Treatment of simultaneously occurring urticaria and atopic dermatitis with dupilumab]. Hautarzt. 2020; 72(3):249-251. DOI: 10.1007/s00105-020-04675-3. View

Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica G . The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014; 69(7):868-87. DOI: 10.1111/all.12313. View

Maurer M, Zuberbier T, Siebenhaar F, Krause K . Chronische Urtikaria - Was bringt die neue Leitlinie?. J Dtsch Dermatol Ges. 2018; 16(5):585-595. DOI: 10.1111/ddg.13531_g. View

Chen Y, Yu M, Huang X, Tu P, Shi P, Maurer M . Omalizumab treatment and outcomes in Chinese patients with chronic spontaneous urticaria, chronic inducible urticaria, or both. World Allergy Organ J. 2021; 14(1):100501. PMC: 7804987. DOI: 10.1016/j.waojou.2020.100501. View

10.

Zuberbier T, Althaus C, Czarnetzki B . Prevalence of cholinergic urticaria in young adults. J Am Acad Dermatol. 1994; 31(6):978-81. DOI: 10.1016/s0190-9622(94)70267-5. View

11.

Gaig P, Olona M, Munoz Lejarazu D, Caballero M, Dominguez F, Echechipia S . Epidemiology of urticaria in Spain. J Investig Allergol Clin Immunol. 2004; 14(3):214-20. View

12.

Wedi B, Raap U, Wieczorek D, Kapp A . Urticaria and infections. Allergy Asthma Clin Immunol. 2010; 5(1):10. PMC: 2804274. DOI: 10.1186/1710-1492-5-10. View

13.

Altrichter S, Fok J, Jiao Q, Kolkhir P, Pyatilova P, Romero S . Total IgE as a Marker for Chronic Spontaneous Urticaria. Allergy Asthma Immunol Res. 2021; 13(2):206-218. PMC: 7840871. DOI: 10.4168/aair.2021.13.2.206. View

14.

Iriarte Sotes P, Armisen M, Usero-Barcena T, Rodriguez Fernandez A, Otero Rivas M, Gonzalez M . Efficacy and Safety of Up-dosing Antihistamines in Chronic Spontaneous Urticaria: A Systematic Review of the Literature. J Investig Allergol Clin Immunol. 2020; 31(4):282-291. DOI: 10.18176/jiaci.0649. View

15.

Mellerowicz E, Weller K, Zuberbier T, Maurer M, Altrichter S . . J Dtsch Dermatol Ges. 2019; 17(11):1141-1149. DOI: 10.1111/ddg.13979_g. View

16.

Hawro T, Ohanyan T, Schoepke N, Metz M, Peveling-Oberhag A, Staubach P . The Urticaria Activity Score-Validity, Reliability, and Responsiveness. J Allergy Clin Immunol Pract. 2017; 6(4):1185-1190.e1. DOI: 10.1016/j.jaip.2017.10.001. View

17.

Kaplan A . Therapy of chronic urticaria: a simple, modern approach. Ann Allergy Asthma Immunol. 2014; 112(5):419-25. DOI: 10.1016/j.anai.2014.02.014. View

18.

Asero R, Bavbek S, Blanca M, Blanca-Lopez N, Cortellini G, Nizankowska-Mogilnicka E . Clinical management of patients with a history of urticaria/angioedema induced by multiple NSAIDs: an expert panel review. Int Arch Allergy Immunol. 2012; 160(2):126-33. DOI: 10.1159/000342424. View

19.

Maurer M, Eyerich K, Eyerich S, Ferrer M, Gutermuth J, Hartmann K . Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020. Int Arch Allergy Immunol. 2020; 181(5):321-333. PMC: 7265766. DOI: 10.1159/000507218. View

20.

Altrichter S, Chuamanochan M, Knoth H, Asady A, Ohanyan T, Metz M . Real-life treatment of cholinergic urticaria with omalizumab. J Allergy Clin Immunol. 2018; 143(2):788-791.e8. DOI: 10.1016/j.jaci.2018.08.050. View