Omalizumab in chronic spontaneous urticaria: steroid sparing effect

奥马佐单抗 医学 中止 恶化 不利影响 类固醇使用 皮肤病科 重症监护医学 外科 儿科 内科学 免疫球蛋白E 免疫学 抗体
作者
Alessia Gatta,Loredana Della Valle,Anila Farinelli,E. Cavallucci,Roberto Paganelli,Mario Di Gioacchino
出处
期刊:Journal of Dermatological Treatment [Informa]
卷期号:29 (sup3): 6-9 被引量:3
标识
DOI:10.1080/09546634.2018.1527988
摘要

Omalizumab has been recognized to be effective in the treatment of chronic spontaneous urticaria (CSU). The Italian Medicines Agency authorizes two omalizumab courses, only for patients with CSU unresponsive to antihistamines, and this schedule may limit omalizumab use. Unfortunately, in the majority of CSU, the schedule is unsatisfactory because symptoms usually recur shortly after discontinuation of treatment. A case of a patient needing more than two treatment courses with omalizumab is reported, in order to discuss the rationale for its long-term use. Patient had needed systemic steroids almost continuously for 4 years. Two severe glucocorticoid-associated adverse events (GAEs) occurred during long-term treatment. Omalizumab 300 mg monthly was started with immediate disappearance of the urticarial lesions. Beneficial effects waned shortly after discontinuation of treatment, and further steroid use was needed. A second omalizumab course showed the same clinical pattern, with prompt response and recurrence of symptoms after suspension. Therefore, we decided to repeat the 6 months omalizumab treatment as soon as symptoms recurred, to avoid further emergency steroid treatments and GAEs. This experience suggests that long-term use of omalizumab could be useful. Evidences show that omalizumab is effective and safe for re-treatment and long-term use of responding patients after recurrence.
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