Biomarkers of response to omalizumab in patients with chronic spontaneous urticaria.

IF 2.1 4区 医学 Q3 ALLERGY
Allergologia et immunopathologia Pub Date : 2025-07-01 eCollection Date: 2025-01-01 DOI:10.15586/aei.v53i4.1343
Özge Öztürk Aktaş, Dilek Öksüzer Çimşir, Esra Nur Bülbül, Neyran Şerbetçi, Türkan Zeynep Fendoğlu, Esra İnan, Begüm Görgülü Akın, Şengül Beyaz, Zeynep Çelebi Sözener, Şadan Soyyiğit
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引用次数: 0

Abstract

Background and objectives: Managing chronic spontaneous urticaria (CSU) resistant to anti-histamines remains challenging, and predictors of omalizumab efficacy are not fully understood. This study evaluated omalizumab's effectiveness, response patterns, and predictors in CSU patients.

Materials and methods: A retrospective analysis was conducted on 72 patients receiving omalizumab for at least six months. Factors influencing response to anti-IgE therapy were examined.

Results: Among the 72 patients with chronic spontaneous urticaria (CSU), 86.1% responded to omalizumab: 58.3% had a good response (UAS-7 <6), 27.8% showed a partial response, and 13.9% were non-responders. Baseline total IgE levels were significantly higher in responders compared to non-responders (good: 291.4 kUA/L vs. 60.2 kUA/L, p = 0.003; partial: 148 kUA/L vs. 60.2 kUA/L, p = 0.049). ROC analysis identified a total IgE cut-off of 64 kUA/L for predicting omalizumab response (AUC: 0.67, p = 0.019; sensitivity: 82%, specificity: 48%). Non-responders had significantly higher erythrocyte sedimentation rates (20.0 mm/h vs. 8.25 mm/h, p = 0.018). Patients with recurrence post-treatment had elevated thyroid-stimulating hormone (TSH) and C-reactive protein (CRP) levels (p = 0.006, p = 0.007). Among responders, 29% had an early response and 71% a late response. Early responders had significantly lower anti-thyroglobulin (anti-TG) and antinuclear antibody (ANA) positivity (p = 0.036, p = 0.035). Systemic inflammatory indices (SII, SIRI) did not predict response.

Conclusions: Baseline total IgE may predict omalizumab response, while ANA and anti-TG positivity correlate with delayed response. Elevated TSH and CRP levels may indicate a higher recurrence risk after treatment discontinuation.

慢性自发性荨麻疹患者对omalizumab反应的生物标志物。
背景和目的:治疗抗组胺药耐药的慢性自发性荨麻疹(CSU)仍然具有挑战性,omalizumab疗效的预测因素尚不完全清楚。本研究评估了omalizumab在CSU患者中的有效性、反应模式和预测因素。材料和方法:回顾性分析72例接受奥玛单抗治疗至少6个月的患者。观察影响抗ige治疗反应的因素。结果:72例慢性自发性荨麻疹(CSU)患者中,86.1%对奥玛珠单抗有应答,58.3%有良好应答(UAS-7)。结论:基线总IgE可预测奥玛珠单抗应答,而ANA和抗tg阳性与延迟应答相关。TSH和CRP水平升高可能表明停药后复发风险较高。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.
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