Omalizumab in elderly patients with chronic spontaneous urticaria: An Italian real-life experience.

Abstract

BACKGROUND:

Omalizumab therapy is effective and safe in patients with chronic spontaneous urticaria (CSU) resistant to nonsedating histamine1 (H1) antihistamines (nsAHs).

OBJECTIVE:

To evaluate the efficacy and safety of omalizumab in elderly (aged ≥65 years) patients with nonsedating H1-antihistamine-refractory CSU in a real-life setting.

METHODS:

Patients with nonsedating H1-antihistamine-refractory CSU (n = 322) treated with omalizumab administered every 4 weeks in doses of 300 mg for 24 weeks were divided into 2 groups according to age at omalizumab treatment onset: 15 to 64 years and 65 years or older. Treatment response was assessed using a 7-day urticaria activity score (UAS7). Adverse effects of omalizumab therapy were recorded.

RESULTS:

Among patients, 32 (9.9%) were 65 years or older. At baseline, CSU characteristics were generally similar among the groups, although the presence of angioedema was statistically significantly lower in patients younger than 65 years. Any differences in weekly itch severity score, hive score, and UAS7 between the 2 age groups were not significant at weeks 4, 12, and 24, with the exception of the hive score at 24 weeks and the UAS7 at week 24. No significant between-group differences were seen in the proportion of patients with a UAS7 of 6 or lower and with a UAS7 score of 0 at weeks 4, 12, 24, and 40. The proportion of patients with at least one adverse event reported as suspected to be caused by study drug was 10% in the younger group vs 6.3% in the older group (P = .53).

CONCLUSION:

Our study found that omalizumab is a well-tolerated and effective therapy for elderly patients with nonsedating H1-antihistamine-refractory CSU.

• Authors: Eustachio Nettis, Luca Cegolon, Elisabetta Di Leo, Walter Giorgio Canonica, Aikaterini Detoraki, Italian OCUReL Study Group
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 120 Issue 3 Pg. 318-323 (03 2018) ISSN: 1534-4436 [Electronic] United States
• PMID: 29508719 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Allergic Agents
• Histamine H1 Antagonists
• Omalizumab

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Allergic Agents (therapeutic use)
• Chronic Disease
• Drug Resistance
• Female
• Histamine H1 Antagonists (therapeutic use)
• Humans
• Male
• Middle Aged
• Omalizumab (therapeutic use)
• Treatment Outcome
• Urticaria (drug therapy)
• Young Adult