1 - Immunoallergy Department, Hospital Dona Estefânia, CHULC EPE, Lisbon, Portugal
2 - Dermatology Department, Hospital Santo António dos Capuchos, CHULC EPE, Lisbon, Portugal
- EAACI Congress 2021, reunião internacional, apresentação sob a forma de poster
Resumo:
Introdução: Chronic Spontaneous Urticaria (CSU) is defined as the recurrence of spontaneous itchy hives and/or angioedema for a period longer than 6 weeks. Treatment is usually started with antihistamines (anti-H1) but Omalizumab (OMZ), an anti-IgE monoclonal antibody, is now a third-line option for patients refractory to quadruple doses of anti-H1, emerging as a promising agent in improving our patients’ quality of life.
Objetivos: We aimed to contribute with real-life data by describing our experience in two departments of a tertiary center: Allergy and Clinical Immunology and Dermatology.
Métodos: We performed a retrospective analysis of CSU patients treated with OMZ, in terms of sex, age, urticaria duration, total IgE and urticaria activity score over 7 days (UAS7) before and after OMZ, length of remission after OMZ cessation, adverse events and relevant comorbidities. We considered complete responders (CR) patients who achieved UAS7< 6 under OMZ in monotherapy; partial responders (PR) those in need of daily medication in addition to OMZ for UAS7<6 and non-responders (NR) those who persistently remained UAS7> 6.
Resultados: We can identify 24 CSU patients treated with OMZ [16 female; median age: 49 years old (P25-75:39-59)]. Besides CSU, twelve (50%) patients also had angioedema. Atopic comorbidities were present in 58% (n=14), being rhinitis the most frequently reported (29%). Other comorbidities included arterial hypertension in 37.5% (n=9), depressive syndrome (n=7) and thyroid disorders (n= 4). The median time (P25-75) between CSU onset and the first administration of OMZ was 2y (1-3). Pre-OMZ, the median total IgE was 151 KUA/L and the median UAS7 was 28. Ten patients were CR, 7 PR, and 7 NR. The mean number of administrations to achieve UAS7=0 was 4. Two CR patients already stopped OMZ with no relapse of the disease, with remission time ranging from 1 to 6 months. Non-severe adverse reactions to OMZ were observed in two patients and did not lead to therapeutic discontinuation. We couldn’t find any statistically significant relationship between the evaluated parameters and the response to OMZ, probably due to our small sample size.
Conclusões: Our results show that OMZ is an often effective treatment for intractable CSU that has a good safety profile. The more patients we have, the better we can understand the benefits of using OMZ. Therefore, we highlight the importance of both departments sharing their experience with data that reflect real-life experience.
Palavras Chave: Chronic Spontaneous Urticaria, Omalizumab