Omalizumab in the treatment of chronic urticaria.
Omalizumab is a monoclonal anti-immunoglobulin E antibody currently only approved for use in severe, refractory asthma. In recent years, many authors have reported satisfactory results with omalizumab in patients with difficult-to-treat chronic urticaria. As a result, clinical trials were undertaken to broaden the indication of omalizumab to include chronic urticaria, and the drug was recently cited as a third-line treatment after selective antihistamines at high doses in a consensus document on the treatment of chronic urticaria. In this article our aim is to provide a comprehensive update on the use of omalizumab in the treatment of chronic urticaria. The structure of this biologic agent and its possible mechanisms of actions in this setting will be presented. Treatment strategies and the different dosage regimens used in the series of cases published to date will also be reviewed. Finally, we will discuss the adverse effects that may arise with treatment and the recommended strategies for minimizing the most feared effect, anaphylaxis. Based on the experience of many researchers, omalizumab is emerging as a novel treatment for certain types of spontaneous refractory chronic urticaria and has shown promising results in this setting. The drug has a good safety profile and the main limitation is its high cost.
Sección de Dermatología, Hospital General Universitario de Alicante, Alicante, España. Electronic address: laura.frances@hotmail.com.
L
L
Francés
Sección de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
M
M
Leiva-Salinas
Sección de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
J F
JF
Silvestre
D018926:Anti-Allergic Agents / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D015337:Multicenter Studies as Topic; D000069444:Omalizumab; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D017455:Receptors, IgE / Q000037:antagonists & inhibitors; D014581:Urticaria / Q000188:drug therapy*
D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D017455:Receptors, IgE; D000069444:Omalizumab; D007073:Immunoglobulin E
Anti-immunoglobulin E; Anti-inmunoglobulina E; Chronic urticaria; Omalizumab; Tratamiento; Treatment; Urticaria crónica