Omalizumab withdrawal outcomes in chronic spontaneous urticaria are linked with baseline IgE and eosinophil levels.

Autor:	Maoz-Segal R; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Levenberg G; Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel., Levy T; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Haj-Yahia S; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Shavit R; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Machnes-Maayan D; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel., Lifshitz-Tunitsky Y; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel., Niznik S; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Offengenden I; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel., Iancovich-Kidon M; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel., Agmon-Levin N; The Clinical Immunology, Angioedema and Allergy Unit, Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel.
Jazyk:	angličtina
Zdroj:	The World Allergy Organization journal [World Allergy Organ J] 2024 May 04; Vol. 17 (5), pp. 100905. Date of Electronic Publication: 2024 May 04 (Print Publication: 2024).
DOI:	10.1016/j.waojou.2024.100905
Abstrakt:	Background: Chronic Spontaneous Urticaria (CSU) is an immune-mediated skin disease that may require prolonged treatments. Currently, there are no recommendations for treatment discontinuation once CSU symptoms are controlled, particularly among patients primarily diagnosed with severe CSU. Objective: In this real-life study we aimed to describe our experience of omalizumab (Oma) treatment withdrawal in CSU and define biomarkers related to these outcomes. Methods: CSU patients followed at our allergy clinic from January 2016 to December 2022 were included. Response to Oma therapy, and Oma-withdrawal outcomes among patients who reached complete remission for >6 months were analyzed. Results: During the study period 192/335(%) CSU patients were categorized as severe-CSU and entitled to receive Oma according to our country's regulations. Of them, 131/192(68%) were considered "Oma-responders", and 95/131(72.5%) patients underwent gradual treatment withdrawal. Successful Oma-withdrawal was documented in 47/95(49.5%) whereas 48/95(50.5%) patients experienced flare and were defined as unsuccessful OMA-withdrawal. The first was associated with shorter disease duration 7.1 ± 7.4 years vs. 10.7 ± 9.4 (P = 0.042), lower baseline-IgE 81.6 ± 84.1IU/ml vs. 324.7 ± 555.9 (P = 0.005), and lower baseline-eosinophils count 131.4 ± 110.5 vs. 195.6 ± 98.4 (P = 0.043) in comparison to failure of Oma-withdrawal group. Conclusion: OMA may be successfully withdrawn in up to 50% of severe CSU patients following complete remission of disease symptoms, utilizing a gradual withdrawal protocol. Oma-withdrawal failure was linked with longer duration of disease as well as high IgE and eosinophil counts prior to initiation of Oma therapy. These parameters may enable the design of a treatment withdrawal algorithm. Competing Interests: None. (© 2024 The Authors.)
Databáze:	MEDLINE
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