Abstract
Background: Chronic spontaneous urticaria (CSU) is defined as spontaneous occurrence of wheals and/or angioedema for ≥6 weeks. Omalizumab is a monoclonal anti-IgE antibody effective in refractory CSU, but its mechanism of action and markers predictive of response remain not completely defined. Objectives: To correlate baseline levels of two proposed biomarkers, total IgE (bIgE) and d-dimer (bd-dimer), and clinical parameters to omalizumab response and to relapses after drug withdrawal. Methods: In this retrospective Italian multicentre study, clinical data were collected in 470 CSU patients, and bIgE and bd-dimer were measured in 340 and 342 patients, respectively. Disease activity was determined by Urticaria Activity Score 7 (UAS7) at week 1 and 12 after omalizumab starting. Relapses were evaluated during a 2- and 3-month interval after a first and a second course of treatment, respectively. Results: bIgE correlated to a good response to omalizumab since levels were significantly higher in responders than non-responders (P = 0.0002). Conversely, bd-dimer did not correlate to response. There was no correlation between both bIgE and d-dimer and either first or second relapse. Disease duration was significantly longer in patients who experienced either first or second relapse (P < 0.0001 and P = 0.0105, respectively), while baseline UAS7 correlated only to first relapse (P = 0.0023). Conclusions: Our study confirms bIgE as a reliable biomarker predicting response to omalizumab in CSU, while it does not support the usefulness of bd-dimer unlike previous findings. CSU duration before omalizumab and baseline UAS7 may be clinical markers of relapse risk.
| Original language | English |
|---|---|
| Pages (from-to) | 918-924 |
| Journal | Journal of the European Academy of Dermatology and Venereology |
| Volume | 33 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2019 |
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ASJC Scopus subject areas
- Dermatology
- Infectious Diseases
Cite this
Predictors of response to omalizumab and relapse in chronic spontaneous urticaria : a study of 470 patients. / Marzano, A. V.; Genovese, G.; Casazza, G.; Fierro, M. T.; Dapavo, P.; Crimi, N.; Ferrucci, S.; Pepe, P.; Liberati, S.; Pigatto, P. D.; Offidani, A.; Martina, E.; Girolomoni, G.; Rovaris, M.; Foti, C.; Stingeni, L.; Cristaudo, A.; Canonica, G. W.; Nettis, E.; Asero, R.
In: Journal of the European Academy of Dermatology and Venereology, Vol. 33, No. 5, 2019, p. 918-924.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of response to omalizumab and relapse in chronic spontaneous urticaria
T2 - a study of 470 patients
AU - Marzano, A. V.
AU - Genovese, G.
AU - Casazza, G.
AU - Fierro, M. T.
AU - Dapavo, P.
AU - Crimi, N.
AU - Ferrucci, S.
AU - Pepe, P.
AU - Liberati, S.
AU - Pigatto, P. D.
AU - Offidani, A.
AU - Martina, E.
AU - Girolomoni, G.
AU - Rovaris, M.
AU - Foti, C.
AU - Stingeni, L.
AU - Cristaudo, A.
AU - Canonica, G. W.
AU - Nettis, E.
AU - Asero, R.
PY - 2019
Y1 - 2019
N2 - Background: Chronic spontaneous urticaria (CSU) is defined as spontaneous occurrence of wheals and/or angioedema for ≥6 weeks. Omalizumab is a monoclonal anti-IgE antibody effective in refractory CSU, but its mechanism of action and markers predictive of response remain not completely defined. Objectives: To correlate baseline levels of two proposed biomarkers, total IgE (bIgE) and d-dimer (bd-dimer), and clinical parameters to omalizumab response and to relapses after drug withdrawal. Methods: In this retrospective Italian multicentre study, clinical data were collected in 470 CSU patients, and bIgE and bd-dimer were measured in 340 and 342 patients, respectively. Disease activity was determined by Urticaria Activity Score 7 (UAS7) at week 1 and 12 after omalizumab starting. Relapses were evaluated during a 2- and 3-month interval after a first and a second course of treatment, respectively. Results: bIgE correlated to a good response to omalizumab since levels were significantly higher in responders than non-responders (P = 0.0002). Conversely, bd-dimer did not correlate to response. There was no correlation between both bIgE and d-dimer and either first or second relapse. Disease duration was significantly longer in patients who experienced either first or second relapse (P < 0.0001 and P = 0.0105, respectively), while baseline UAS7 correlated only to first relapse (P = 0.0023). Conclusions: Our study confirms bIgE as a reliable biomarker predicting response to omalizumab in CSU, while it does not support the usefulness of bd-dimer unlike previous findings. CSU duration before omalizumab and baseline UAS7 may be clinical markers of relapse risk.
AB - Background: Chronic spontaneous urticaria (CSU) is defined as spontaneous occurrence of wheals and/or angioedema for ≥6 weeks. Omalizumab is a monoclonal anti-IgE antibody effective in refractory CSU, but its mechanism of action and markers predictive of response remain not completely defined. Objectives: To correlate baseline levels of two proposed biomarkers, total IgE (bIgE) and d-dimer (bd-dimer), and clinical parameters to omalizumab response and to relapses after drug withdrawal. Methods: In this retrospective Italian multicentre study, clinical data were collected in 470 CSU patients, and bIgE and bd-dimer were measured in 340 and 342 patients, respectively. Disease activity was determined by Urticaria Activity Score 7 (UAS7) at week 1 and 12 after omalizumab starting. Relapses were evaluated during a 2- and 3-month interval after a first and a second course of treatment, respectively. Results: bIgE correlated to a good response to omalizumab since levels were significantly higher in responders than non-responders (P = 0.0002). Conversely, bd-dimer did not correlate to response. There was no correlation between both bIgE and d-dimer and either first or second relapse. Disease duration was significantly longer in patients who experienced either first or second relapse (P < 0.0001 and P = 0.0105, respectively), while baseline UAS7 correlated only to first relapse (P = 0.0023). Conclusions: Our study confirms bIgE as a reliable biomarker predicting response to omalizumab in CSU, while it does not support the usefulness of bd-dimer unlike previous findings. CSU duration before omalizumab and baseline UAS7 may be clinical markers of relapse risk.
UR - http://www.scopus.com/inward/record.url?scp=85058013579&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058013579&partnerID=8YFLogxK
U2 - 10.1111/jdv.15350
DO - 10.1111/jdv.15350
M3 - Article
AN - SCOPUS:85058013579
VL - 33
SP - 918
EP - 924
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
SN - 0926-9959
IS - 5
ER -