Artigo Acesso aberto Produção Nacional Revisado por pares

Omalizumab in Chronic Spontaneous Urticaria: A Brazilian Real-Life Experience

2016; Karger Publishers; Volume: 169; Issue: 2 Linguagem: Inglês

10.1159/000444985

ISSN

1423-0097

Autores

Luís Felipe Ensina, Solange Oliveira Rodrigues Valle, Ana Paula Juliani, Michel Galeane, R. Vieira dos Santos, L. Karla Arruda, Janaína Michelle Lima Melo, Patrícia Karla de Souza, Faradiba Sarquis Serpa, Djanira Andrade, Alfeu Tavares França, Régis A. Campos, Inês Cristina Camelo‐Nunes, Dirceu Solé,

Tópico(s)

Autoimmune Bullous Skin Diseases

Resumo

Current guidelines on chronic spontaneous urticaria (CSU) suggest a treatment based on a 3-step approach that aims at total symptom control, starting with H1-antihistamines. However, a significant number of patients present an antihistamine-resistant urticaria that must be treated with an alternative third-line therapy such as omalizumab.Patients with a history of CSU who did not respond to treatment with high doses of modern antihistamines were treated with 150 or 300 mg of omalizumab every 4 weeks. The response to treatment was recorded as complete (CR), partial (PR) or no response. A dose adjustment was proposed according to response.We treated 47 CSU patients with omalizumab (40 females), of whom 39.5% had evidence of autoimmunity. The average number of treatments was 11.4 (range 2-87). All patients had been refractory to high-dose modern antihistamines. A CR was seen in 84.6% of patients who started with 300 mg and in 60% of those who started with 150 mg. Only 1 patient had no response to both the 150- and 300-mg doses. In 6 of the PR patients with 150 mg, a higher dose of 300 mg was proposed and 4 had a CR. Four patients discontinued the treatment. No severe adverse events were reported in the patients who finished the study.Although good results were seen in both groups, CR rates were higher in those under a high-dose initial treatment. Our data strongly suggest that the therapy should be individualized.

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