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J Allergy Clin Immunol. 2018 Feb;141(2):638-649. doi: 10.1016/j.jaci.2017.06.032. Epub 2017 Jul 24.

Omalizumab treatment in patients with chronic inducible urticaria: A systematic review of published evidence.

Author information

1
Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany. Electronic address: marcus.maurer@charite.de.
2
Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
3
Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Germany.
4
Klinik für Dermatologie und Venerologie, Vivantes-Klinikum Berlin-Neukölln, Berlin, Germany.
5
Department of Dermatology and Allergology, University Medical Center Gießen (UKGM), Justus Liebig University Gießen, Giessen, Germany.
6
Department of Dermatology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.
7
Department of Dermatology, Saarland University Medical School, Homburg/Saar, Germany.
8
Hautklinik und Poliklinik der Universitätsmedizin Mainz, Mainz, Germany.
9
the Leipzig Interdisciplinary Allergy Center (LICA), Department of Dermatology, Venereology and Allergology, University Medical Center, Leipzig, Germany.
10
Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Germany.

Abstract

BACKGROUND:

Omalizumab, a recombinant anti-IgE antibody, effectively treats chronic spontaneous urticaria. Evidence is lacking in patients with chronic inducible urticarias (CIndUs), which are frequently H1-antihistamine resistant.

OBJECTIVE:

From the current published literature, we aimed to determine the strength of evidence for omalizumab efficacy and safety in the treatment of CIndUs.

METHODS:

We performed a PubMed search to identify evidence on omalizumab use in the following 9 CIndU subtypes: symptomatic dermographism, cold urticaria, delayed-pressure urticaria, solar urticaria, heat urticaria, vibratory angioedema, cholinergic urticaria, contact urticaria, and aquagenic urticaria.

RESULTS:

Forty-three trials, case studies, case reports, and analyses were identified. Our review indicates that omalizumab has substantial benefits in patients with various CIndUs. The evidence is strongest for symptomatic dermographism, cold urticaria, and solar urticaria. Little/no evidence was available on vibratory angioedema and aquagenic and contact urticaria. Our review supports rapid onset of action demonstrated through early symptom control in most cases, sometimes within 24 hours. Many patients gained complete/partial symptom relief and substantially improved quality of life. Adverse events were generally low, with omalizumab being well tolerated by most patients, including children.

CONCLUSIONS:

A strong body of evidence supports the use of omalizumab in the treatment of patients with therapy-refractory CIndU. More data from randomized controlled studies are warranted.

KEYWORDS:

IgE; cholinergic urticaria; physical urticaria; symptomatic dermographism; therapy

PMID:
28751232
DOI:
10.1016/j.jaci.2017.06.032
[Indexed for MEDLINE]

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