Omalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: can we define better-responding endotypes?
| Autor: | Emek Kocatürk, Emel Bülbül Başkan, Özlem Su Küçük, Mustafa Özdemir, Sinem Örnek, Pelin Kuteyla Can, Eda Haşal, Burhan Engin, Nilgün Atakan, Erkan Alpsoy |
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| Přispěvatelé: | Göncü, Özgür Emek Kocatürk (ORCID 0000-0003-2801-0959 & YÖK ID 217219), Başkan, Emel Bülbül, Küçük, Özlem Su, Özdemir, Mustafa, Örnek, Sinem, Can, Pelin Kuteyla, Hasal, Eda, Engin, Burhan, Atakan, Nilgün, Alpsoy, Erkan, School of Medicine, SU KÜÇÜK, ÖZLEM |
| Rok vydání: | 2022 |
| Předmět: |
Urticaria
BIOMARKERS Omalizumab Dermatology Sağlık Bilimleri Clinical Medicine (MED) Health Sciences Anti-Allergic Agents Humans Klinik Tıp (MED) Chronic Urticaria Angioedema Biomarker Chronic urticaria Cyclosporine Dermatoloji Retrospective Studies Internal Medicine Sciences Klinik Tıp Dahili Tıp Bilimleri CLINICAL MEDICINE Tıp DERMATOLOJİ Treatment Outcome Chronic Disease Medicine Female |
| Zdroj: | Anais Brasileiros de Dermatologia Anais Brasileiros de Dermatologia v.97 n.5 2022 Anais brasileiros de dermatologia Sociedade Brasileira de Dermatologia (SBD) instacron:SBD Anais Brasileiros de Dermatologia, Volume: 97, Issue: 5, Pages: 592-600, Published: 30 SEP 2022 |
| ISSN: | 0365-0596 |
| DOI: | 10.1016/j.abd.2022.03.003 |
| Popis: | Background: chronic Spontaneous Urticaria (CSU) is characterized by recurrent wheals and/or angioedema for longer than 6-weeks. Guidelines recommend Omalizumab (Oma) as first-line and Cyclosporine-A (Cs-A) as second-line treatment in antihistamine resistant CSU. This step-wise algorithm might be time-consuming and costly. Objective: to determine indicators of response to Oma or Cs-A in CSU patients. Methods: we retrospectively analyzed data from seven centers in Turkey; the inclusion criteria for patients were to receive both Oma and Cs-A treatment (not concurrently) at some point in time during their follow-up. Clinical and laboratory features were compared between groups. Results: among 110 CSU patients; 47 (42.7%) were Oma-responders, 15 (13.6%) were Cs-A-responders, and 24 (21.8%) were both Oma and Cs-A responders and 24 (21.8%) were non-responders to either drug. High CRP levels were more frequent in Cs-A-responders (72.7% vs. 40.3%; p = 0.055). Oma-responders had higher baseline UCT (Urticaria Control Test) scores (6 vs. 4.5; p = 0.045). Responders to both drugs had less angioedema and higher baseline UCT scores compared to other groups (33.3% vs. 62.8%; p = 0.01 and 8 vs. 5; p = 0.017). Non-responders to both drugs had an increased frequency in the female gender and lower baseline UCT scores compared to other groups (87.5% vs. 61.6%; p = 0.017 and 5 vs. 7; p = 0.06). Study Limitations: retrospective nature, limited number of patients, no control group, the lack of the basophil activation (BAT) or BHRA (basophil histamine release assay) tests. Conclusions: baseline disease activity assessment, which considers the presence of angioedema and disease activity scores, gender, and CRP levels might be helpful to predict treatment outcomes in CSU patients and to choose the right treatment for each patient. Categorizing patients into particular endotypes could provide treatment optimization and increase treatment success. NA |
| Databáze: | OpenAIRE |
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