Consensus on management of chronic urticaria using anti-immunoglobulin E therapy (omalizumab）

2021 ◽  
Keyword(s):  
Chronic Urticaria ◽  
Immunoglobulin E

scholarly journals URTICARIAL VASCULITIS IN CHILDREN

2021 ◽  
Vol 2021 (3) ◽  
pp. 16-29
Author(s):  
O. M. Оkhotnikova ◽  
O. A. Oshlyanskaya
Keyword(s):  
Rare Disease ◽  
Chronic Urticaria ◽  
Immunoglobulin E ◽  
Combined Treatment ◽  
Urticarial Vasculitis ◽  
Complement Components ◽  
National Healthcare ◽  
Low Efficiency ◽  
Hypocomplementemic Urticarial Vasculitis Syndrome ◽  
Hypocomplementemic Urticarial Vasculitis

URTICARIAL VASCULITIS IN CHILDREN O. M. Оkhotnikova, O. A. Oshlyanskaya Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine Abstract. Different autoimmune diseases can present with organs malfunctioning and chronic urticaria symptoms in particular such urticarial vasculitis. This variant of vasculitis can be a separate nosological form, which includes a rare disease as hypocomplementemic urticarial vasculitis syndrome. In addition to chronic urticaria symptoms, hypocomplementemic urticarial vasculitis syndrome is characterized by severe systemic manifestations in different organs, decreased serum level of complement components, and appearance of specific markers, such as anti-C1q-antibodies. The diagnosis is confirmed by the results of skin biopsy, which is the «gold standard» of diagnosis. The condition often requires combined treatment with two immunosuppressive drugs. Hypocomplementemic urticarial vasculitis syndrome is a very rare disease, but, because of the multisystem manifestations, it can be encountered by any specialist (pediatrician, general practitioner, allergist, rheumatologist, ophthalmologist, dermatologist, nephrologist, etc.), therefore doctors should consider this condition when dealing with such patients in order to reduce the risk of hypocomplementemic urticarial vasculitis syndrome misdiagnosis as the variants of chronic urticaria or another immunopathogenetic disease. That is why doctors should be well aware of the features of the course of this disease, not only to reduce the likelihood of erroneous diagnosis of urticarial vasculitis as chronic urticaria or another disease of immunopathological genesis, but also because modern therapy of these conditions is radically different from each other: сhronic idiopathic urticaria requires adherence to a modern patient management algorithm with the initial use of H1-antihistamines with a possible increase in the dose (up to a 4-fold increase), and with their low efficiency — the transition to the use of cytostatics, monoclonal antibodies against immunoglobulin E –omalizumab, and is extremely limited and only for short-term use of glucocorticosteroids. Key words: urticarial vasculitis, its forms, hypocomplementemia, chronic urticaria, children. Olena Okhotnikova MD, PhD, professor, Head Department of Pediatrics #1, Shupyk National Healthcare University of Ukraine, 9, Dorogozhytska str., 04112, Kyiv, Ukraine e-mail: [email protected] Аsthma and Allergy, 2021, 3, P. 16–29.

scholarly journals Advances in Understanding and Managing Chronic Urticaria

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 177 ◽  
Author(s):  
Yasmin Moolani ◽  
Charles Lynde ◽  
Gordon Sussman
Keyword(s):  
Chronic Urticaria ◽  
Immunoglobulin E ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Fold Increase ◽  
Line Treatment ◽  
Physical Urticaria ◽  
Chronic Inducible Urticaria ◽  
Autoimmune Urticaria ◽  
Inducible Urticaria

There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA2LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options.

scholarly journals Chronic Spontaneous Urticaria – Diagnosis and Management

2021 ◽  
Author(s):  
Evmorfia Ladoyanni
Keyword(s):  
Chronic Urticaria ◽  
Psychological Factors ◽  
Immunoglobulin E ◽  
Immunoglobulin A ◽  
Life Quality ◽  
Chronic Spontaneous Urticaria ◽  
Specific Stimulus ◽  
Chronic Inducible Urticaria ◽  
Number Of Patients ◽  
Inducible Urticaria

Chronic urticaria can be subclassified into chronic spontaneous urticaria and chronic inducible urticaria. Up to 30% of cases are associated with functional immunoglobulin G antibodies to the high affinity immunoglobulin E receptor FcεRIα or to immunoglobulin A. Pathogenic activation of mast cells and basophils gives rise to release of pro-inflammatory mediators that lead to development of hives. CSU is a debilitating disease with a relapsing course. It affects 0.5–1% of the population at any given time. The duration of CSU is generally 1–5 years but can be longer in cases associated with angioedema and autoreactivity. CSU has detrimental effects on life quality with sleep-deprivation and psychiatric disorders being the most frequent. In a great number of patients an underlying cause or eliciting factor cannot be identified. Among the patients in which an aetiology is suspected, infections, medication, food and psychological factors are most commonly associated. A potential autoimmune cause has been reported in up to 50% of patients. Chronic inducible urticaria is characterised by its ability to be triggered consistently and reproducibly in response to a specific stimulus (pressure, temperature, vibration, water, heat, light). Antihistamines form the mainstay of therapy. In recalcitrant chronic urticaria, a variety of other drugs have been tried.

Significantly High Levels of Anti-dsDNA Immunoglobulin E in Sera and the Ability of dsDNA to Induce the Degranulation of Basophils from Chronic Urticaria Patients

2013 ◽  
Vol 161 (s2) ◽  
pp. 154-158 ◽  
Author(s):  
Yuko Hatada ◽  
Jun-ichi Kashiwakura ◽  
Koremasa Hayama ◽  
Daisuke Fujisawa ◽  
Tomomi Sasaki-Sakamoto ◽  
...  
Keyword(s):  
Chronic Urticaria ◽  
Immunoglobulin E

A patient with steroids and antihistaminic drug allergy and newly occurred chronic urticaria angioedema

2013 ◽  
Vol 33 (8) ◽  
pp. 882-885 ◽  
Author(s):  
A Kutlu ◽  
E Karabacak ◽  
E Aydin ◽  
S Ozturk ◽  
B Bozkurt
Keyword(s):  
Case Report ◽  
Allergic Reaction ◽  
Female Patient ◽  
Skin Test ◽  
Chronic Urticaria ◽  
Drug Allergy ◽  
Immunoglobulin E ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Antihistaminic Drug

In this case report, successful use of omalizumab in the treatment of chronic urticarial and angioedema in a 24-year-old female patient with an allergic reaction history to almost every drug including steroids and antihistamines was presented. She also had allergy against a large number of foods, which were confirmed by oral provocation, specific Immunoglobulin E and allergy skin test.

Immunobiologic treatments for severe asthma, atopic dermatitis, and chronic urticaria

2019 ◽  
Vol 40 (6) ◽  
pp. 485-489
Author(s):  
Sergio E. Chiarella
Keyword(s):  
Atopic Dermatitis ◽  
Severe Asthma ◽  
Chronic Urticaria ◽  
Immunoglobulin E ◽  
Allergic Diseases ◽  
Therapeutic Alternative

Immunobiologic agents are an important therapeutic alternative for severe asthma, atopic dermatitis, and chronic urticaria. In this article, we reviewed the most relevant studies that addressed the use of anti-immunoglobulin E (omalizumab), anti-IL-5 (mepolizumab, reslizumab, and benralizumab), and anti-IL-4/IL-13 (dupilumab) treatments for these allergic diseases. In addition, we discussed emerging immunobiologic therapies, such as tezepelumab.

Chronic Urticaria

2005 ◽  
Vol 36 (2) ◽  
pp. 50
Author(s):  
Elizabeth Mechcatie ◽  
Nancy Walsh
Keyword(s):  
Chronic Urticaria

New Assay Takes Sting Out of Chronic Urticaria

2007 ◽  
Vol 38 (4) ◽  
pp. 37
Author(s):  
BRUCE K. DIXON
Keyword(s):  
Chronic Urticaria
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