Login Register Cart 0
Generic placeholder image

Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 1871-5230
ISSN (Online): 1875-614X

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Omalizumab in the Treatment of Chronic Urticaria: The Effect of Drug Co-Administration and Co-Morbidities

Author(s): Anna Tagka, George I. Lambrou*, Electra Nicolaidou, Evangelia Nakou, Michael Makris, Alexandros Stratigos and Alexandra Katsarou

Volume 20, Issue 1, 2021

Published on: 03 February, 2020

Page: [39 - 50] Pages: 12

DOI: 10.2174/1871523019666200203123734

Price: $65

Abstract

Background: Chronic Spontaneous Urticaria (CSU) is a disease presenting typical wheals characterized by itching, angioedema or both. Although CU is, by appearance, a relatively “simple” disease, yet it has a devastating effect on those suffering due to its immense social implications.

Aims: The aim of the present study was to investigate the effect of omalizumab in the treatment of CSU. In particular, gender, co-administration of drugs and comorbidities were taken into account.

Materials and Methods: 108 patients (25 Males/83 Females) admitted to our department were diagnosed with CSU and were treated for 30 months. CSU was estimated on a score basis, which was used in order to define disease severity. The mean total CSU score and the mean CSU score of the first trimester, as well as the first semester, were calculated. Patients were treated with omalizumab, and in several cases, with co-administration of dapsone, cyclosporine and anti-histamines.

Results: Females manifested significantly higher scores as compared to males. Further on, patients who relapsed manifested significantly higher scores during the whole time course, as well as at the end of the first semester.

Conclusion: Females are more prone to CSU. Although CSU scores in patients with remission, relapse and poor response manifested no significant difference at diagnosis, relapsed patients manifested higher CSU scores in the first semester. Therefore, the first semester of treatment is probably critical for the final patient outcome. Further studies are necessary in order to understand the mechanisms of CSU for better treatment and prognosis.

Keywords: Chronic spontaneous urticaria, chronic urticaria, cyclosporine, dapsone, omalizumab, prevalence, relapse.

« Previous Next »
Graphical Abstract

[1]
Toubi, E.; Kessel, A.; Avshovich, N.; Bamberger, E.; Sabo, E.; Nusem, D.; Panasoff, J. Clinical and laboratory parameters in predicting chronic urticaria duration: A prospective study of 139 patients. Allergy, 2004, 59(8), 869-873.
[http://dx.doi.org/10.1111/j.1398-9995.2004.00473.x] [PMID: 15230821]
[2]
van der Valk, P.G.; Moret, G.; Kiemeney, L.A. The natural history of chronic urticaria and angioedema in patients visiting a tertiary referral centre. Br. J. Dermatol., 2002, 146(1), 110-113.
[http://dx.doi.org/10.1046/j.1365-2133.2002.04582.x PMID: 11841375]
[3]
Gaig, P.; Olona, M.; Muñoz Lejarazu, D.; Caballero, M.T.; Domínguez, F.J.; Echechipia, S.; García Abujeta, J.L.; Gonzalo, M.A.; Lleonart, R.; Martínez Cócera, C.; Rodríguez, A.; Ferrer, M. Epidemiology of urticaria in Spain. J. Investig. Allergol. Clin. Immunol., 2004, 14(3), 214-220.
[PMID: 15552715]
[4]
Maurer, M.; Weller, K.; Bindslev-Jensen, C.; Giménez-Arnau, A.; Bousquet, P.J.; Bousquet, J.; Canonica, G.W.; Church, M.K.; Godse, K.V.; Grattan, C.E.; Greaves, M.W.; Hide, M.; Kalogeromitros, D.; Kaplan, A.P.; Saini, S.S.; Zhu, X.J.; Zuberbier, T. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy, 2011, 66(3), 317-330.
[http://dx.doi.org/10.1111/j.1398-9995.2010.02496.x] [PMID: 21083565]
[5]
Beltrani, V.S. An overview of chronic urticaria. Clin. Rev. Allergy Immunol., 2002, 23(2), 147-169.
[http://dx.doi.org/10.1385/CRIAI:23:2:147] [PMID: 12221861]
[6]
Sánchez-Borges, M.; Caballero-Fonseca, F.; Capriles-Hulett, A.; González-Aveledo, L.; Maurer, M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J. Eur. Acad. Dermatol. Venereol., 2017, 31(6), 964-971.
[http://dx.doi.org/10.1111/jdv.14221] [PMID: 28299827]
[7]
Zuberbier, T.; Maurer, M. Urticaria: Current opinions about etiology, diagnosis and therapy. Acta Derm. Venereol., 2007, 87(3), 196-205.
[PMID: 17533484]
[8]
Kolkhir, P.; Church, M.K.; Weller, K.; Metz, M.; Schmetzer, O.; Maurer, M. Autoimmune chronic spontaneous urticaria: What we know and what we do not know. J. Allergy Clin. Immunol., 2017, 139(6), 1772-1781.
[9]
Asero, R.; Tedeschi, A.; Marzano, A.V.; Cugno, M. Chronic urticaria: A focus on pathogenesis. F1000 Res., 2017, 6, 1095.
[http://dx.doi.org/10.12688/f1000research.11546.1 ] [PMID: 28751972]
[10]
Zuberbier, T.; Aberer, W.; Asero, R.; Abdul Latiff, A.H.; Baker, D.; Ballmer-Weber, B.; Bernstein, J.A.; Bindslev-Jensen, C.; Brzoza, Z.; Buense Bedrikow, R.; Canonica, G.W.; Church, M.K.; Craig, T.; Danilycheva, I.V.; Dressler, C.; Ensina, L.F.; Giménez-Arnau, A.; Godse, K.; Gonçalo, M.; Grattan, C.; Hebert, J.; Hide, M.; Kaplan, A.; Kapp, A.; Katelaris, C.H.; Kocatürk, E.; Kulthanan, K.; Larenas-Linnemann, D.; Leslie, T.A.; Magerl, M.; Mathelier-Fusade, P.; Meshkova, R.Y.; Metz, M.; Nast, A.; Nettis, E.; Oude-Elberink, H.; Rosumeck, S.; Saini, S.S.; Sánchez-Borges, M.; Schmid-Grendelmeier, P.; Staubach, P.; Sussman, G.; Toubi, E.; Vena, G.A.; Vestergaard, C.; Wedi, B.; Werner, R.N.; Zhao, Z.; Maurer, M. The EAACI/GA2LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy, 2018, 73(7), 1393-1414.
[http://dx.doi.org/10.1111/all.13397] [PMID: 29336054]
[11]
Ferrer, M.; Boccon-Gibod, I.; Gonçalo, M.; İnalöz, H.S.; Knulst, A.; Lapeere, H.; Parthasaradhi, A.; Stingl, G.; Tagka, A.; Valenzuela, F.; Yeung, J.; Thomsen, S.F. Expert opinion: defining response to omalizumab in patients with chronic spontaneous urticaria. Eur. J. Dermatol., 2017, 27(5), 455-463.
[http://dx.doi.org/10.1684/ejd.2017.3085] [PMID: 29084635]
[12]
Siebenhaar, F.; Staubach, P.; Metz, M.; Magerl, M.; Jung, J.; Maurer, M. Peltier effect-based temperature challenge: an improved method for diagnosing cold urticaria. J. Allergy Clin. Immunol., 2004, 114(5), 1224-1225.
[http://dx.doi.org/10.1016/j.jaci.2004.07.018] [PMID: 15536435]
[13]
Magerl, M.; Altrichter, S.; Borzova, E.; Giménez-Arnau, A.; Grattan, C.E.; Lawlor, F.; Mathelier-Fusade, P.; Meshkova, R.Y.; Zuberbier, T.; Metz, M.; Maurer, M. The definition, diagnostic testing, and management of chronic inducible urticarias - The EAACI/GA(2) LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy, 2016, 71(6), 780-802.
[http://dx.doi.org/10.1111/all.12884] [PMID: 26991006]
[14]
Hollis, K.; Proctor, C.; McBride, D.; Balp, M.M.; McLeod, L.; Hunter, S.; Tian, H.; Khalil, S.; Maurer, M. Comparison of urticaria activity score over 7 days (UAS7) values obtained from once-daily and twice-daily versions: Results from the assure-csu study. Am. J. Clin. Dermatol., 2018, 19(2), 267-274.
[http://dx.doi.org/10.1007/s40257-017-0331-8] [PMID: 29368043]
[15]
Młynek, A.; Zalewska-Janowska, A.; Martus, P.; Staubach, P.; Zuberbier, T.; Maurer, M. How to assess disease activity in patients with chronic urticaria? Allergy, 2008, 63(6), 777-780.
[http://dx.doi.org/10.1111/j.1398-9995.2008.01726.x] [PMID: 18445192]
[16]
Firooz, A.; Akhlaghi, A.; Golbidi, P.; Pourjafari, M.; Abdollahimajd, F.; Azimi, H.; Banihashemi, M.; Darvish Damavandi, F.; Erfani, A.R.; Farajzadeh, S.; Ghassemi, M.; Gheisari, M.; Hamedpour, K.; Handjani, F.; Hashemi, S.A.; Herizchi, H.; Iraji, F.; Jalili, H.; Khatami, A.; Lajevardi, V.; Mansouri, P.; Masjedi, H.; Mehrian, P.; Mohammadi, S.; Mohebbi, A.; Namazi, N.; Nasiri Kashani, M.; Radmehr, A.; Safar, F.; Saffarian, Z.; Saneei, S.; Seirafi, H.; Taheri, S.; Yazdanpanah, M.J.; Zaboli Nejad, N.; Naseri, M.; Peiravi, P.; Teymori, G. Real life management of chronic urticaria: Multicenter and cross sectional study on patients and dermatologists in Iran. Dermatol. Ther. (Heidelb.), 2019, 32(2)e12796
[http://dx.doi.org/10.1111/dth.12796] [PMID: 30520195]
[17]
Maillet, F.; Wolff, D.; Soria, A.; Adnet, F.; Panayotopoulos, V.; Gobert, D.; Lapostolle, F.; Reuter, P.G.; Ghazali, A.; Caux, F.; Fain, O.; Javaud, N. Factors associated with relapses among patients treated for acute urticaria. J. Dermatol., 2019, 46(5), 383-388.
[http://dx.doi.org/10.1111/1346-8138.14830] [PMID: 30816579]
[18]
Rosman, Y.; Hershko, A.Y.; Meir-Shafrir, K.; Kedem, R.; Lachover-Roth, I.; Mekori, Y.A.; Confino-Cohen, R. Characterization of chronic urticaria and associated conditions in a large population of adolescents. J. Am. Acad. Dermatol., 2019, 81(1), 129-135.
[http://dx.doi.org/10.1016/j.jaad.2019.02.034] [PMID: 30797847]
[19]
Morgan, M.; Cooke, A.; Rogers, L.; Adams-Huet, B.; Khan, D.A. Double-blind placebo-controlled trial of dapsone in antihistamine refractory chronic idiopathic urticaria. J. Allergy Clin. Immunol. Pract., 2014, 2(5), 601-606.
[http://dx.doi.org/10.1016/j.jaip.2014.06.004] [PMID: 25213055]
[20]
Yancey, K.B. Commentary regarding Double-blind placebo-controlled trial of dapsone in antihistamine refractory chronic idiopathic urticaria by M Morgan, A Cooke, L Rogers, B Adams-Huet, DA Khan. J Allergy Clin Immunol Pract 2:601-606, 2014. Dermatol. Ther. (Heidelb.), 2015, 28(2), 102-103.
[http://dx.doi.org/10.1111/dth.12201] [PMID: 25649343]
[21]
Liang, S.E.; Hoffmann, R.; Peterson, E.; Soter, N.A. Use of dapsone in the treatment of chronic idiopathic and autoimmune urticaria. JAMA Dermatol., 2019, 155(1), 90-95.
[http://dx.doi.org/10.1001/jamadermatol.2018.3715 ] [PMID: 30476976]
[22]
Casale, T.B.; Bernstein, J.A.; Maurer, M.; Saini, S.S.; Trzaskoma, B.; Chen, H.; Grattan, C.E.; Gimenéz-Arnau, A.; Kaplan, A.P.; Rosén, K. Similar efficacy with omalizumab in chronic idiopathic/spontaneous urticaria despite different background therapy. J. Allergy Clin. Immunol. Pract., 2015, 3(5), 743-750.
[http://dx.doi.org/10.1016/j.jaip.2015.04.015] [PMID: 26054553]
[23]
Cherrez-Ojeda, I.; Vanegas, E.; Mata, V.L.; Felix, M.; Ramon, G.D.; Cherrez, S.; Cherrez, A. Autoimmune thyroid disease and urticarial vasculitis: Is there a significant association? Allergy Asthma Clin. Immunol., 2019, 15, 25.
[http://dx.doi.org/10.1186/s13223-019-0339-0] [PMID: 31019538]
[24]
Rodriguez-Castro, K.I.; Franceschi, M.; Miraglia, C.; Russo, M.; Nouvenne, A.; Leandro, G.; Meschi, T. De’ Angelis, G.L.; Di Mario, F. Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed., 2018, 89(8-S), 100-103.
[PMID: 30561426]
[25]
Najafipour, M.; Zareizadeh, M.; Najafipour, F. Relationship between chronic urticaria and autoimmune thyroid disease. J. Adv. Pharm. Technol. Res., 2018, 9(4), 158-161.
[http://dx.doi.org/10.4103/japtr.JAPTR_342_18] [PMID: 30637235]
[26]
Kitsioulis, N.A.; Papadopoulos, N.G.; Kostoudi, S.; Manousakis, E.; Douladiris, N.; Xepapadaki, P. Assessment of atopic dermatitis as a risk factor for chronic spontaneous urticaria in a pediatric population. Allergy Asthma Proc., 2018, 39(6), 445-448.
[http://dx.doi.org/10.2500/aap.2018.39.4166] [PMID: 30401321]
[27]
Süß, H.; Dölle-Bierke, S.; Geier, J.; Kreft, B.; Oppel, E.; Pföhler, C.; Skudlik, C.; Worm, M.; Mahler, V. Contact urticaria: Frequency, elicitors and cofactors in three cohorts (information network of departments of dermatology; network of Anaphylaxis; and department of dermatology, university hospital Erlangen, Germany). Contact Dermat., 2019, 81(5), 341-353.
[http://dx.doi.org/10.1111/cod.13331 ] [PMID: 31173644]
[28]
Choonhakarn, C.; Chaowattanapanit, S.; Julanon, N. The treatment outcomes and dose de-escalation of desloratadine up-dosing in chronic spontaneous urticaria. Int. J. Dermatol., 2018, 57(4), 423-427.
[http://dx.doi.org/10.1111/ijd.13919] [PMID: 29380864]
[29]
Powell, R.J.; Leech, S.C.; Till, S.; Huber, P.A.; Nasser, S.M.; Clark, A.T. BSACI guideline for the management of chronic urticaria and angioedema. Clin. Exp. Allergy, 2015, 45(3), 547-565.
[http://dx.doi.org/10.1111/cea.12494] [PMID: 25711134]

Rights & Permissions Print Cite
Article Metrics
25
3
© 2024 Bentham Science Publishers | Privacy Policy