Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey.
Allergol Immunopathol (Madr). 2020 Jul-Aug;48(4):368-373. doi: 10.1016/j.aller.2020.03.011. Epub 2020 May 25.
Omalizumab is useful as an add-on treatment in patients unresponsive to high doses of second-generation antihistamines. This study aimed to evaluate the efficacy and safety of omalizumab treatment in adolescents with refractory chronic spontaneous urticaria (CSU).
CSU patients aged 12-18 years old with the diagnosis of symptomatic CSU and unresponsive to classical treatment were included in the study. All patients had an urticaria-activity-score (UAS7) of ≥16 or and were treated with 300mg omalizumab every four weeks. The degree of response was classified into complete, partial and non-responders due to UAS7.
A total of 29 patients were evaluated. The median age and symptom onset age of the patients was 15.2 (IQR, 12.8-16.5) years and 14.0 (IQR, 11.8-15.9) years, respectively. The median duration of urticaria was eight (IQR, 4-24) months at admission. Eleven (37.9%) patients had angioedema and ten (34.5%) patients had concomitant allergic diseases. The median age at the beginning of treatment with omalizumab was 15.4 (IQR, 12.9-16.9) years. The median symptom duration was 12 (IQR, 6.5-27.5) months before the omalizumab treatment. Twenty-eight (96.5%) of the patients (89.6% complete, 6.9% partial) achieved response; however, one patient was a non-responder (3.5%). The adverse effect was observed in one (3.4%) patient as angioedema after the third dose. Twenty-three patients were followed up for a median of 18 (IQR, 13-27) months. Relapse was observed in three (13%) patients.
Omalizumab is considered as an effective and safe treatment for CSU in adolescents. Relapses mostly occur within the first year after the cessation of treatment.
奥马珠单抗作为二线抗组胺药物治疗抵抗患者的附加治疗是有效的。本研究旨在评估奥马珠单抗治疗青少年难治性慢性自发性荨麻疹（CSU）的疗效和安全性。
纳入诊断为症状性 CSU 且对经典治疗无反应的 12-18 岁 CSU 患者。所有患者的荨麻疹活动评分（UAS7）≥16 或对奥马珠单抗 300mg 每四周一次的治疗有反应。根据 UAS7 将反应程度分为完全、部分和无反应者。
共评估了 29 例患者。患者的中位年龄和症状发病年龄分别为 15.2（IQR，12.8-16.5）岁和 14.0（IQR，11.8-15.9）岁。入院时荨麻疹的中位病程为 8（IQR，4-24）个月。11 例（37.9%）患者有血管性水肿，10 例（34.5%）患者有合并的过敏性疾病。开始奥马珠单抗治疗的中位年龄为 15.4（IQR，12.9-16.9）岁。奥马珠单抗治疗前的中位症状持续时间为 12（IQR，6.5-27.5）个月。28 例（96.5%）患者（89.6%完全缓解，6.9%部分缓解）达到缓解；然而，1 例患者无反应（3.5%）。1 例（3.4%）患者在第三次剂量后出现血管性水肿的不良反应。23 例患者中位随访 18（IQR，13-27）个月。3 例（13%）患者复发。
奥马珠单抗被认为是青少年 CSU 的一种有效且安全的治疗方法。停药后第一年复发较多。
