Allergology Clinic, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
Eur Ann Allergy Clin Immunol. 2021 Nov;53(6):263-266. doi: 10.23822/EurAnnACI.1764-1489.167. Epub 2020 Sep 11.
The response to Omalizumab by patients with severe Chronic Spontaneous Urticaria (CSU), may be rapid, slow, or absent. An early response has been associated with an IgE-mediated auto-allergic pathogenic mechanism, whereas little is known about slow and non-responders. To compare CSU patients responding slowly or non-responding to Omalizumab. Forty-six patients showing a slow (n= 23) or absent (n= 23) response to Omalizumab out of a cohort of 170 patients with severe CSU (UAS-7 major 30) were studied. Several baseline clinical and serological parameters were compared in the two groups. Apart from a lower prevalence of atopic diseases (p minor 0.05) and a slightly higher prevalence of thyroid autoimmunity in non-responders, the two groups were similar in terms of clinical and serological features. The majority of patients in both groups showed low baseline total IgE levels. Patients with severe CSU showing a slow response or not responding at all to omalizumab show impressive similarities. It is currently not possible to predict whether patients with severe CSU and low IgE levels will show a slow response or will not respond to anti-IgE treatment.
患有严重慢性自发性荨麻疹（CSU）的患者对奥马珠单抗的反应可能是迅速的、缓慢的或不存在的。早期反应与 IgE 介导的自身过敏发病机制有关，而对于缓慢反应者和无反应者知之甚少。 比较对奥马珠单抗反应缓慢或无反应的 CSU 患者。 在 170 例严重 CSU（UAS-7 主要 30）患者队列中，有 46 例患者对奥马珠单抗表现出缓慢（n=23）或无反应（n=23）。比较了两组的几个基线临床和血清学参数。 除了在无反应者中特应性疾病的患病率较低（p 次要 0.05）和甲状腺自身免疫的患病率略高外，两组在临床和血清学特征方面相似。两组中的大多数患者基线总 IgE 水平较低。 对奥马珠单抗反应缓慢或无反应的严重 CSU 患者表现出惊人的相似之处。目前尚无法预测基线 IgE 水平较低的严重 CSU 患者是否会对抗 IgE 治疗出现缓慢反应或无反应。
