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ORIGINAL RESEARCH article
Front. Allergy
Sec. Therapies and Therapeutic Targets
Volume 5 - 2024 |
doi: 10.3389/falgy.2024.1464466
The prevalence of patients suffering from chronic spontaneous urticaria, in whom omalizumab cannot be stopped even after six years
Provisionally accepted- 1 Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
- 2 Hillel Yaffe Medical Center, Hadera, Israel
- 3 Holy Family Hospital Nazareth, Nazareth, Northern District, Israel
Background: Omalizumab (OMA) was the first FDA-approved biological drug for severe chronic spontaneous urticaria (CSU), and until today is the only beneficial and truly safe one. The objectives were: To assess the prevalence of CSU patients in whom OMA cannot be stopped over time. We also asked if biomarkers (e.g. anti-TPO antibodies and total IgE) could assist in anticipating this issue. Methods: We used our prospective registry of 93 patients, which included CSU disease duration, the onset of OMA treatment, Urticaria Activity Score (UAS7) during follow-up, co-morbidities, serum IgE levels and the presence of anti-TPO antibodies. Finally, we assessed the response to OMA during a period of six years. Results: Out of the 93 treated CSU patients, OMA was stopped in ten patients after six months being defined as failures. In another ten patients, OMA was discontinued after 2-4 years of therapy, achieving a remission. Seventy-three patients are still treated between 2-6 years, having different degrees of response. Of these, in thirty-eight (52%) patients, we could not stop OMA even after six years due to CSU relapses. The prevalence of lower serum IgE levels and anti-TPO antibody positivity was significantly higher in CSU patients in whom OMA could not be stopped. Conclusion: This is the first study where OMA-treated CSU patients were followed up to six years. In half of them, long-term therapy of six years is still required.
Keywords: Omalizumab, CSU, IgE, anti-TPO, Asthma, Autoimmunity
Received: 14 Jul 2024; Accepted: 09 Sep 2024.
Copyright: Ā© 2024 Vadasz, Schichter-Konfino, Mubariki and Toubi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zahava Vadasz, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
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