Predictors of treatment control in severe chronic urticaria treated with omalizumab.

IF 2.1 Q3 ALLERGY
Asia Pacific Allergy Pub Date : 2025-09-01 Epub Date: 2025-01-08 DOI:10.5415/apallergy.0000000000000162
Miguel Proença, João Marcelino, João Vieira, Joana Guimarães, Carlota Dias, Elza Tomaz
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引用次数: 0

Abstract

Background: Real-life clinical research on biomarkers that predict therapy outcomes of severe chronic spontaneous urticaria patients receiving omalizumab (OMA) therapy is still limited. For this reason, we aimed to identify biomarkers that predict the response to OMA treatment.

Methods: A single-center, observational, retrospective review of patients with severe chronic urticaria treated with OMA from January 2015 to January 2023 in a Portuguese Immunology and Allergy Department. One-way ANOVA and linear regression were used.

Results: Data on 56 OMA-treated chronic spontaneous urticaria patients shows patients can be divided into 3 groups according to their response to OMA. The first group of 26 patients (46.4%) successfully reduced their IMA dose without experiencing any rebound effects. The second group of 19 (33.9%) patients achieved disease control but could not tolerate a progressive dose reduction, and the third group of 11 (19.6%) patients, required a higher dose to achieve disease control. In group 1, patient age and a favorable clinical response had a positive correlation (P = 0.008). The patient's age was also correlated to the time interval until a dose reduction was tolerated (r = 0.69; P = 0.005). There was also a negative correlation between the ratio: thyroid peroxidase antibodies/total-IgE and a favorable clinical response (r = -0.74; P = 0.021). In group 2, thyroid peroxidase antibodies were negatively correlated with a favorable clinical response (r = -0.55; P = 0.027). In group 3, anti-double-stranded DNA was negatively correlated with a favorable clinical response (r = -0,97; P = 0,007).

Conclusion: Our study suggests that older patients experience higher success rates with OMA compared to younger individuals, but increasing age is also associated with a longer interval before achieving successful dose reduction. Potential markers of resistance to OMA identified in our cohort included elevated levels of IgG-antithyroid peroxidase antibodies, positive anti-dsDNA antibodies, and a higher IgG-antithyroid peroxidase/total-IgE ratio.

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奥玛珠单抗治疗严重慢性荨麻疹治疗控制的预测因素。
背景:预测重度慢性自发性荨麻疹患者接受omalizumab (OMA)治疗结果的生物标志物的现实临床研究仍然有限。因此,我们的目标是确定预测OMA治疗反应的生物标志物。方法:对2015年1月至2023年1月在葡萄牙免疫和过敏科接受OMA治疗的严重慢性荨麻疹患者进行单中心、观察性、回顾性研究。采用单因素方差分析和线性回归。结果:56例经OMA治疗的慢性自发性荨麻疹患者资料显示,根据患者对OMA的反应可分为3组。第一组26名患者(46.4%)成功地减少了IMA剂量,没有出现任何反弹效应。第二组19例(33.9%)患者实现了疾病控制,但不能耐受逐渐减少的剂量,第三组11例(19.6%)患者需要更高的剂量才能实现疾病控制。在第一组中,患者年龄与良好的临床反应呈正相关(P = 0.008)。患者的年龄也与耐受减量的时间间隔相关(r = 0.69; P = 0.005)。甲状腺过氧化物酶抗体/总ige的比值也与良好的临床反应呈负相关(r = -0.74; P = 0.021)。在第二组中,甲状腺过氧化物酶抗体与良好的临床反应呈负相关(r = -0.55; P = 0.027)。在第3组中,抗双链DNA与良好的临床反应呈负相关(r = -0,97; P = 0,007)。结论:我们的研究表明,与年轻人相比,老年患者的OMA成功率更高,但年龄的增加也与成功减少剂量的间隔时间更长有关。在我们的队列中发现的OMA耐药的潜在标志包括igg -抗甲状腺过氧化物酶抗体水平升高,抗dsdna抗体阳性,以及igg -抗甲状腺过氧化物酶/总ige比值较高。
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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
33
期刊介绍: Asia Pacific Allergy (AP Allergy) is the official journal of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI). Although the primary aim of the journal is to promote communication between Asia Pacific scientists who are interested in allergy, asthma, and clinical immunology including immunodeficiency, the journal is intended to be available worldwide. To enable scientists and clinicians from emerging societies appreciate the scope and intent of the journal, early issues will contain more educational review material. For better communication and understanding, it will include rational concepts related to the diagnosis and management of asthma and other immunological conditions. Over time, the journal will increase the number of original research papers to become the foremost citation journal for allergy and clinical immunology information of the Asia Pacific in the future.
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