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Int Arch Allergy Immunol ; 169(2): 121-4, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27055122

RESUMEN

BACKGROUND: Current guidelines on chronic spontaneous urticaria (CSU) suggest a treatment based on a 3-step approach that aims at total symptom control, starting with H1-antihistamines. However, a significant number of patients present an antihistamine-resistant urticaria that must be treated with an alternative third-line therapy such as omalizumab. METHODS: Patients with a history of CSU who did not respond to treatment with high doses of modern antihistamines were treated with 150 or 300 mg of omalizumab every 4 weeks. The response to treatment was recorded as complete (CR), partial (PR) or no response. A dose adjustment was proposed according to response. RESULTS: We treated 47 CSU patients with omalizumab (40 females), of whom 39.5% had evidence of autoimmunity. The average number of treatments was 11.4 (range 2-87). All patients had been refractory to high-dose modern antihistamines. A CR was seen in 84.6% of patients who started with 300 mg and in 60% of those who started with 150 mg. Only 1 patient had no response to both the 150- and 300-mg doses. In 6 of the PR patients with 150 mg, a higher dose of 300 mg was proposed and 4 had a CR. Four patients discontinued the treatment. No severe adverse events were reported in the patients who finished the study. DISCUSSION: Although good results were seen in both groups, CR rates were higher in those under a high-dose initial treatment. Our data strongly suggest that the therapy should be individualized.


Asunto(s)
Antialérgicos/uso terapéutico , Omalizumab/uso terapéutico , Urticaria/tratamiento farmacológico , Urticaria/inmunología , Adolescente , Adulto , Anciano , Antialérgicos/administración & dosificación , Brasil , Enfermedad Crónica , Resistencia a Medicamentos , Femenino , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Masculino , Persona de Mediana Edad , Omalizumab/administración & dosificación , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
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