PMID- 38113870
OWN - NLM
STAT- MEDLINE
DCOM- 20240305
LR  - 20240313
IS  - 1423-0097 (Electronic)
IS  - 1018-2438 (Linking)
VI  - 185
IP  - 3
DP  - 2024
TI  - Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria.
PG  - 260-266
LID - 10.1159/000535414 [doi]
AB  - INTRODUCTION: The possible influence of sensitization to aeroallergens on 
      omalizumab response in chronic spontaneous urticaria (CSU) has been 
      insufficiently investigated. This study's aim was to investigate atopy's 
      influence on omalizumab response in CSU patients. METHOD: Retrospective study of 
      CSU patients followed at a Portuguese Urticaria Center of Reference and 
      Excellence (UCARE), treated with omalizumab for at least 6 months, between 2015 
      and 2022. At T0, all patients underwent quantification of specific immunoglobulin 
      E (IgE) for total extract of most prevalent aeroallergens (ImmunoCAP Thermo 
      Fisher Scientific(R)) and were divided in 2 groups, according to their response to 
      omalizumab during the first 16 weeks of treatment: responders (R) (UAS7 <7) 
      versus partial (PR) (UAS7 = 7-15) and nonresponders (UAS7 >15). R were further 
      classified as fast (FR) (4-6 weeks) and slow responders (SR) (12-16 weeks). Total 
      serum IgE, circulating eosinophil, and basophil counts were compared between 
      groups at T0. p < 0.05 was considered statistically significant (SPSS(R) v25.0). 
      RESULTS: Ninety-six patients (80% female) were studied, mean age 49 +/- 14 years. 
      Median CSU duration pre-omalizumab was 3 (0.6-20) years and mean omalizumab 
      treatment duration was 3.7 +/- 2.3 years. 38 (40%) had concomitant chronic 
      inducible urticaria and 72 (75%) angioedema. Based on positive results of the 
      specific IgE assay, 35 patients (36%) were considered atopic. Most patients (n = 
      30; 86%) were sensitized to house dust mites (HDM) (Dermatophagoides farinae = 
      28, Dermatophagoides pteronyssinus = 27, Blomia tropicalis = 19, Lepidoglyphus 
      destructor = 17), followed by pollens (n = 12; 34%) (mixture of grasses = 10, 
      Olea europaea = 7, Parietaria officinalis = 6), epithelia (n = 9; 26%) (dog = 8, 
      cat = 7), and fungi (Alternaria alternata = 4; 11%). Eight patients (23%) were 
      monosensitized to HDM and 4 (11%) to pollens. No significant association was 
      found between aeroallergen sensitization and CSU duration, concomitant chronic 
      inducible urticaria, or angioedema. Atopic patients featured significantly higher 
      levels of baseline total serum IgE than nonatopic (469 vs. 94 U/mL, respectively; 
      p = 0.0009). Mean baseline counts of eosinophils and basophils were not 
      significantly different between atopic and non-atopic, respectively: eosinophils 
      (128 vs. 121/mm3) and basophils (26 vs. 28/mm3). Regarding response to 
      omalizumab, most patients (58; 60%) were responders: FR - 46 (79%); SR - 12 
      (21%). There was no significant association between aeroallergen sensitization 
      and omalizumab response or speed of response. CONCLUSIONS: As far as we know, 
      this is the first study exploring the influence of atopy sensitization pattern on 
      omalizumab response in CSU. According to our results, presence of 
      atopy/sensitization pattern does not influence omalizumab response in CSU 
      patients.
CI  - (c) 2023 S. Karger AG, Basel.
FAU - Costa, Celia
AU  - Costa C
AD  - Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar 
      Universitario Lisboa Norte, Lisbon, Portugal.
AD  - Clinica Universitaria de Imunoalergologia, Centro Academico de Medicina de 
      Lisboa, Faculdade de Medicina de Lisboa, Lisbon, Portugal.
FAU - Esteves Caldeira, Leonor
AU  - Esteves Caldeira L
AD  - Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar 
      Universitario Lisboa Norte, Lisbon, Portugal.
FAU - Paulino, Marisa
AU  - Paulino M
AD  - Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar 
      Universitario Lisboa Norte, Lisbon, Portugal.
FAU - Santos, Diana F
AU  - Santos DF
AD  - Instituto de Medicina Molecular Joao Lobo Antunes, Faculdade de Medicina, 
      Universidade de Lisboa, Lisbon, Portugal.
FAU - Silva, Susana L
AU  - Silva SL
AD  - Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar 
      Universitario Lisboa Norte, Lisbon, Portugal.
AD  - Clinica Universitaria de Imunoalergologia, Centro Academico de Medicina de 
      Lisboa, Faculdade de Medicina de Lisboa, Lisbon, Portugal.
LA  - eng
PT  - News
DEP - 20231219
PL  - Switzerland
TA  - Int Arch Allergy Immunol
JT  - International archives of allergy and immunology
JID - 9211652
RN  - 0 (Anti-Allergic Agents)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 2P471X1Z11 (Omalizumab)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Angioedema
MH  - *Anti-Allergic Agents/therapeutic use
MH  - Chronic Disease
MH  - Chronic Inducible Urticaria
MH  - *Chronic Urticaria/drug therapy
MH  - Immunoglobulin E
MH  - Omalizumab/therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Urticaria/drug therapy
OTO - NOTNLM
OT  - Atopy
OT  - Chronic spontaneous urticaria
OT  - Omalizumab response
OT  - Sensitization patterns
OT  - UCARE
EDAT- 2023/12/19 19:55
MHDA- 2024/03/05 06:46
CRDT- 2023/12/19 18:26
PHST- 2023/10/04 00:00 [received]
PHST- 2023/11/21 00:00 [accepted]
PHST- 2024/03/05 06:46 [medline]
PHST- 2023/12/19 19:55 [pubmed]
PHST- 2023/12/19 18:26 [entrez]
AID - 000535414 [pii]
AID - 10.1159/000535414 [doi]
PST - ppublish
SO  - Int Arch Allergy Immunol. 2024;185(3):260-266. doi: 10.1159/000535414. Epub 2023 
      Dec 19.