ABSTRACT
Objective:
To investigate the
efficacy and
safety of
omalizumab in the
treatment of
chronic urticaria (CU)
patients with poor response to H1
antihistamines.
Methods:
CU
patients,
who showed poor response to H1
antihistamines and received
omalizumab treatment, were collected from the Department of
Dermatology, Xiangya
Hospital, Central South
University from June 2020 to June 2021. The
efficacy of
omalizumab was evaluated by using the 7-day
urticaria activity score (UAS7) and
urticaria control test (UCT) score at weeks 4, 12 and 24 after the start of
treatment. The t-
test, chi-square test, and Pearson correlation
analysis were used to analyze the relationship between the clinical characteristics and
efficacy.
Results:
A total of 121 CU
patients who met the inclusion criteria and had relatively complete
medical records were included in this study, including 54
males (44.63%) and 67
females (55.37%) , and their ages ranged from 13 to 70 years (39.88 ± 14.36 years) ; 88
patients were diagnosed with
chronic spontaneous urticaria (72.73%) , 10 with
chronic inducible urticaria (8.26%) , and 23 with
chronic spontaneous urticaria accompanied by
chronic inducible urticaria (19.01%) . At week 4 after the start of
omalizumab treatment, the response rate was 50.86% (59/116) , and the complete response rate was 25.86% (30/116) ; at week 12, the response rate was 78.26% (54/69) , and the complete response rate was 34.78% (24/69) ; at week 24, the response rate was 64.71% (22/34) , and the complete response rate was 23.53% (8/34) . At week 4, CU
patients with baseline
serum total
IgE levels of < 40 IU/ml had a lower response rate (26 cases, 30.77%) than those with baseline
serum total
IgE levels of ≥ 40 IU/ml (61 cases, 65.57%; χ2 = 8.93, P = 0.004) . Correlation
analysis showed that the age at
treatment,
age at onset, allergic
diseases, concomitant symptoms, baseline
erythrocyte sedimentation rates, and baseline
C-reactive protein levels were significantly correlated with the UCT scores (all P < 0.05) , while the
course of
disease, clinical types,
serum total
IgE levels, peripheral
blood counts,
dermatology life quality index scores, and UAS7 scores were not significantly correlated with the UCT scores. Among the 121 CU
patients, 8 (6.61%) reported mild to moderate adverse reactions.
Conclusion:
Omalizumab could effectively improve clinical
symptoms and signs of CU
patients with poor response to H1
antihistamines, and was well tolerated;
omalizumab treatment may be more beneficial to
patients without allergic comorbidities such as
allergic rhinitis, without concomitant symptoms such as
angioedema, and with lower
erythrocyte sedimentation rates and
C-reactive protein levels.