The effect of omalizumab treatment on hematological inflammatory parameters and immunoglobulin E levels in patients with chronic spontaneous urticaria

Abstract

Objectives: We aimed to evaluate the effect of omalizumab use on hematological parameters, inflammatory markers, and immunoglobulin E (IgE) in patients with chronic spontaneous urticaria and to determine whether there would be any difference between patient and control groups in terms of these values and whether IgE levels before and after omalizumab treatment are correlated with the Urticaria Control Test (UCT). Materials And Methods: Forty-five patients with chronic spontaneous urticaria and 45 healthy controls who presented to the dermatology outpatient clinic of Yozgat Bozok University Research and Training Hospital were analyzed retrospectively. Age, gender, neutrophil, lymphocyte, monocyte, eosinophil, basophil, and thrombocyte counts and IgE values before and after 24 weeks of treatment were recorded, and IgE ratios before and after treatment were calculated. The UCT was performed on the patients. The neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, eosinophil/basophil, and eosinophil/lymphocyte ratios were calculated for the control group and the patient group, both before and after treatment. Mean platelet volume (MPV), which is also considered an inflammatory marker, was recorded before treatment, in both the control group and the patient group. Results: The patients’ median pre-treatment IgE level [189.0 (1.0–1824.0)] was significantly lower than the post-treatment level [561.0 (2.0–4301.0)] (P<0.001). No significant difference was determined in basophil, platelet, eosinophil, monocyte, lymphocyte, and neutrophil counts and neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, eosinophil/basophil, and eosinophil/lymphocyte ratios before and after omalizumab treatment. The mean UCT score of the patients was found to be 11.5 (± 3.9). The mean IgE ratio post-omalizumab treatment/pre-omalizumab treatment was 5.8. No significant difference was found between the patient and control groups regarding neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, eosinophil/basophil, and eosinophil/lymphocyte ratios, as well as MPVs. A significant correlation was found between the patients’ UCT scores and IgE levels after omalizumab treatment (r=0.313; P=0.046). Conclusion: No changes were observed in hematological inflammatory markers of patients with chronic spontaneous urticaria, compared with healthy controls. Besides, no changes were observed in either inflammatory markers or hematological parameters, following the use of omalizumab in these patients. Hence, it is considered that there is no harm in using omalizumab in diseases such as chronic disease anemia, chronic idiopathic neutropenia, and idiopathic thrombocytopenic purpura. The fact that omalizumab treatment caused a significant increase in IgE levels, in correlation with previous studies, made us think that the methods of reducing the dose or extending the dose interval should be preferred, instead of abruptly interrupting the treatment during the discontinuation period to prevent relapses.