Omalizumab for the treatment of chronic spontaneous urticaria: association between body mass index and outcome
Keywords:
omalizumab, Body Mass Index, chronic spontaneous urticariaAbstract
Introduction: Omalizumab has been recently registered as a third-line therapy for chronic spontaneous urticaria.
Objectives: In this study, we aimed to provide real life data by reporting our experience with omalizumab in the treatment of chronic spontaneous urticaria.
Methods: A retrospective data analysis was conducted on 40 patients affected by chronic spontaneous urticaria and treated with omalizumab at the Dermatology Unit of University of Padua, Italy.Demographic, anthropometric, and clinical data have been collected.
Results: Overall, the majority of patients (23 patients, 57.5%) achieved complete recovery by taking omalizumab and 17.5% (7 patients) had a partial response. The majority of patients who did not have a response to omalizumab had a BMI> 25 kg/m2.
Conclusions: Our study suggests that omalizumab is a safe and effective treatment for chronic spontaneous urticaria. We identified BMI as a critical biological factor that significantly impacts the outcomes of omalizumab treatment. Our findings also suggest a potential use of BMI as a predictive biomarker for omalizumab treatment. An updosing of omalizumab may be proposed in patients with high BMI to achieve a better control of the disease.
References
2. Zuberbier T, Aberer W, Asero R, et al: The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy Eur J Allergy Clin Immunol 73(7):1393-1414,2018. DOI:10.1111/all.13397
3. Antia C, Baquerizo K, Korman A, Bernstein JA, Alikhan A: Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol 79(4):599-614, 2018. DOI: 10.1016/j.jaad.2018.01.020
4. Giménez-Arnau AM: Omalizumab for treating chronic spontaneous urticaria: an expert review on efficacy and safety. Expert Opin Biol Ther 17(3):375-385, 2017. DOI:10.1080/14712598.2017.1285903
5. Pelaia C, Calabrese C, Terracciano R: Omalizumab, the first available antibody for biological treatment of severe asthma: more than a decade of real-life effectiveness. Ther Adv Respir Dis 12:1-16, 2018. DOI:10.1177/1753466618810192
6. Maurer M, Rosén K, Hsieh H-J, et al: Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria. N Engl J Med 368(10):924-935, 2013. OI:10.1056/nejmoa1215372
7. Saini SS, Bindslev-Jensen C, Maurer M, et al: Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on h1 antihistamines: A randomized, placebo-controlled study. J Invest Dermatol 135(1):67-75, 2015. DOI:10.1038/jid.2014.306
8. Kaplan A, Ledford D, Ashby M, et al: Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. J Allergy Clin Immunol 132(1):101-109, 2013. DOI: 10.1016/j.jaci.2013.05.013
9. Goldstein S, Gabriel S, Kianifard F, Ortiz B, Skoner DP: Clinical features of adolescents with chronic idiopathic or spontaneous urticaria: Review of omalizumab clinical trials. Ann Allergy Asthma Immunol 118(4): 500–504, 2017. DOI:10.1016/j.anai.2017.02.003
10. Mckeage K: Omalizumab : A Review of its Use in Patients with Severe Persistent Allergic Asthma. Drugs 73 (11): 1197–1212, 2013. DOI:10.1007/s40265-013-0085-4
11. Trinh HK, Pham DL, Ban GY, Lee HY, Parks HS, Ye YM: Altered Systemic Adipokines in Patients with Chronic Urticaria. Int Arch Allergy Immunol 171(2): 102–110, 2016. DOI: 10.1159/000452626
12. Vena GA, Cassano N: The link between chronic spontaneous urticaria and metabolic syndrome. Eur Ann Allergy Clin Immunol 49(5): 208–212, 2017. DOI:10.23822/EurAnnACI.1764-1489.12
13. Magen E, Chikovani T, Waitman DA, Kahan NR. Factors related to omalizumab resistance in chronic spontaneous urticaria. Allergy Asthma Proc. 2019 Jul 1;40(4):273-278. doi: 10.2500/aap.2019.40.4230. PMID: 31262381.
14. Metz M, Vadasz Z, Kocatürk E, Giménez-Arnau AM. Omalizumab Updosing in Chronic Spontaneous Urticaria: an Overview of Real-World Evidence. Clin Rev Allergy Immunol. 2020;59(1):38-45. doi:10.1007/s12016-020-08794-6
15. Kocatürk E, Deza G, Kızıltaç K, Giménez-Arnau AM: Omalizumab Updosing for Better Disease Control in Chronic Spontaneous Urticaria Patients. Int Arch Allergy Immunol 177(4): 360–364, 2018. DOI: 10.1159/000491530
Published
Issue
Section
License
Copyright (c) 2022 Irene Russo, Sara Cazzolla, Francesca Pampaloni, Mauro Alaibac

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.