RESUMEN
Background: The guidelines for the treatment of chronic spontaneous urticaria (CSU) recommend adding omalizumab to the treatment of patients with uncontrolled disease despite four-fold doses of second-generation antihistamines (AH). On the contrary, some studies revealed that omalizumab was effective without concomitant AH and several authors suggest tapering off AH when CSU is controlled with omalizumab. Objectives: The aim of our study was to evaluate the use of AH during treatment with omalizumab in patients with CSU in real clinical practice. Materials & Methods: This was a multicentre cross-sectional and observational study conducted by the Catalan and Balearic Chronic Urticaria Network (XUrCB) based on a cohort of 298 CSU patients treated with omalizumab. Results: In total, 23.5% of our patients decided themselves to stop taking AH during omalizumab treatment. The ratio of patients with CSU without concomitant inducible urticaria and the percentage of patients with a good response to omalizumab (UAS7≤6 and/or UCT ≥12) were higher in those who stopped taking AH. Conclusion: More studies are required to identify the phenotypic characteristics of patients responding to omalizumab as monotherapy in order to avoid overtreating with AH. Our study suggests that patients with CSU without concomitant inducible urticaria and those who achieve a good response to omalizumab tend to be controlled by omalizumab without AH. In order to establish guidelines on how to stop AH, further evidenced-based studies are required.
Asunto(s)
Urticaria Crónica , Urticaria , Humanos , Urticaria Crónica/tratamiento farmacológico , Omalizumab/uso terapéutico , Estudios Transversales , Antagonistas de los Receptores Histamínicos/uso terapéutico , Urticaria/tratamiento farmacológicoRESUMEN
Actualmente no hay ningún fármaco aprobado para el tratamiento de la COVID-19. Se emplean fármacos de manera empírica según experiencia y disponibilidad, pero no existen estudios controlados que demuestren su eficacia y seguridad. En este contexto, es importante que los médicos dispongan de información de los posibles efectos adversos tanto inmunológicos como no inmunológicos de estos medicamentos. En esta revisión se repasa el fundamento para su uso en la infección por SARS-Cov-2, así como las reacciones adversas más frecuentes; no se trata de una revisión sistemática sino narrativa. Se han incluido aquellos fármacos que se utilizan con el fin de abordar adecuadamente las dos fases clínicas que parece tener la enfermedad en su manifestación más grave: una primera fase con predominio de infección viral y una segunda fase con predominio de una respuesta inflamatoria. También se han repasado los casos de reacciones a dichos fármacos recogidas en el Programa de Farmacovigilancia del hospital antes del inicio de la pandemia
Currently, there is no treatment approved for COVID-19. Numerous drugs are being used in an empirical manner according to experience and availability. Studies demonstrating their efficacy and safety are still to be published. Thus, it is of vital importance for healthcare workers to be well informed and updated regarding possible immunological and non-immunological adverse effects regarding such treatments. In this narrative revision, the rationale use of these treatments in the SARS-CoV-2 infection is emphasized as well as their most frequently described adverse drug reactions. Drugs that are being essayed to counteract both clinical phases that are thought to take place in the severe stage of this disease are included; an initial phase where a viral infection prevails and a second phase where an inflammatory response takes over. Adverse reactions registered in the Pharmacovigilance Program of our hospital before the onset of this pandemic have also been included
Asunto(s)
Humanos , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Betacoronavirus/efectos de los fármacos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/virología , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Infecciones por Coronavirus/virología , Neumonía Viral/virología , Pandemias , FarmacovigilanciaRESUMEN
Currently, there is no treatment approved for COVID-19. Numerous drugs are being used in an empirical manner according to experience and availability. Studies demonstrating their efficacy and safety are still to be published. Thus, it is of vital importance for healthcare workers to be well informed and updated regarding possible immunological and non-immunological adverse effects regarding such treatments. In this narrative revision, the rationale use of these treatments in the SARS-CoV-2 infection is emphasized as well as their most frequently described adverse drug reactions. Drugs that are being essayed to counteract both clinical phases that are thought to take place in the severe stage of this disease are included; an initial phase where a viral infection prevails and a second phase where an inflammatory response takes over. Adverse reactions registered in the Pharmacovigilance Program of our hospital before the onset of this pandemic have also been included.
Asunto(s)
Antiinflamatorios/efectos adversos , Antivirales/efectos adversos , Tratamiento Farmacológico de COVID-19 , Antiinflamatorios/uso terapéutico , Antivirales/uso terapéutico , Humanos , Farmacovigilancia , Resultado del TratamientoRESUMEN
Currently, there is no treatment approved for COVID-19. Numerous drugs are being used in an empirical manner according to experience and availability. Studies demonstrating their efficacy and safety are still to be published. Thus, it is of vital importance for healthcare workers to be well informed and updated regarding possible immunological and non-immunological adverse effects regarding such treatments. In this narrative revision, the rationale use of these treatments in the SARS-CoV-2 infection is emphasized as well as their most frequently described adverse drug reactions. Drugs that are being essayed to counteract both clinical phases that are thought to take place in the severe stage of this disease are included; an initial phase where a viral infection prevails and a second phase where an inflammatory response takes over. Adverse reactions registered in the Pharmacovigilance Program of our hospital before the onset of this pandemic have also been included.
Actualmente no hay ningún fármaco aprobado para el tratamiento de la COVID-19. Se emplean fármacos de manera empírica según experiencia y disponibilidad, pero no existen estudios controlados que demuestren su eficacia y seguridad. En este contexto, es importante que los médicos dispongan de información de los posibles efectos adversos tanto inmunológicos como no inmunológicos de estos medicamentos. En esta revisión se repasa el fundamento para su uso en la infección por SARS-Cov-2, así como las reacciones adversas más frecuentes; no se trata de una revisión sistemática sino narrativa.Se han incluido aquellos fármacos que se utilizan con el fin de abordar adecuadamente las dos fases clínicas que parece tener la enfermedad en su manifestación más grave: una primera fase con predominio de infección viral y una segunda fase con predominio de una respuesta inflamatoria. También se han repasado los casos de reacciones a dichos fármacos recogidas en el Programa de Farmacovigilancia del hospital antes del inicio de la pandemia.
RESUMEN
No disponible
