Kulthanan Kanokvalai, Tuchinda Papapit, Chularojanamontri Leena, Likitwattananurak Chayanee, Ungaksornpairote Chanida
a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
J Dermatolog Treat. 2017 Mar;28(2):160-165. doi: 10.1080/09546634.2016.1200710. Epub 2016 Jul 7.
There are limited data regarding omalizumab in the treatment of recalcitrant chronic spontaneous urticaria (CSU) in Asian populations. This study evaluated the effectiveness and the proper dosage of omalizumab for Asian CSU patients in a real-life setting.
We retrospectively reviewed recalcitrant CSU patients seeking treatment at the Skin Allergy Clinic, Siriraj Hospital during the 3-year period. All patients were treated with omalizumab as an add-on therapy. Standard seven-day urticaria activity score (UAS7) and medication score were used to assess omalizumab response.
Of 13 patients, 9 patients (70%) responded well to 150 mg omalizumab injection every month, whereas 4 patients requiring updosing to 300 mg. In the 150 mg group, one patient achieved complete symptom control without antihistamine intake. Most of them required antihistamines without prednisolone and ciclosporin. Onset of omalizumab was fast, usually within the first week. Though only two patients in the 300 mg group achieved complete absence of symptoms, ciclosporin and oral corticosteroids could be discontinued. No patients reported adverse effects.
Omalizumab at an initial dosage of 150 mg was effective in the treatment of recalcitrant CSU among Asians. Updosing to 300 mg was required to achieve satisfactory outcomes.
关于奥马珠单抗治疗亚洲人群顽固性慢性自发性荨麻疹（CSU）的数据有限。本研究在实际临床环境中评估了奥马珠单抗对亚洲CSU患者的有效性和合适剂量。
我们回顾性分析了在3年期间到诗里拉吉医院皮肤过敏诊所寻求治疗的顽固性CSU患者。所有患者均接受奥马珠单抗作为附加治疗。采用标准的7天荨麻疹活动度评分（UAS7）和药物评分来评估奥马珠单抗的疗效。
13例患者中，9例（70%）对每月150mg奥马珠单抗注射反应良好，而4例患者需要增加剂量至300mg。在150mg组中，1例患者在未服用抗组胺药的情况下实现了症状完全控制。他们中的大多数人需要抗组胺药，无需使用泼尼松龙和环孢素。奥马珠单抗起效迅速，通常在第一周内。虽然300mg组只有2例患者实现了症状完全消失，但可以停用环孢素和口服糖皮质激素。没有患者报告不良反应。
初始剂量为150mg的奥马珠单抗对亚洲顽固性CSU患者有效。需要增加剂量至300mg才能取得满意的疗效。
