Korean J Dermatol.  2021 Nov;59(9):685-692.

Analysis of Predictive Factors of Response to Omalizumab Treatment in Chronic Spontaneous Urticaria Patients

• Lee HY
• Koo DW
• Lee JS

Abstract

Background
The European Academy of Allergy and Clinical Immunology guideline for the management of urticaria published in 2018 recommends adding omalizumab as a third-line therapy. However, data on the potential predictive factors of a successful response to omalizumab are limited in Korea. Therefore, this study aimed to perform a retrospective clinical analysis of the effects of omalizumab in a Korean population of patients affected by chronic spontaneous urticaria (CSU).
Objective
To investigate factors affecting the effect of omalizumab treatment and identify factors related to its clinical response.
Methods
We retrospectively reviewed the clinical records of patients with CSU treated with omalizumab at the single-center dermatology department from February 2018 to August 2020. Omalizumab was administered at a single dose of 150 mg every 4 weeks. Clinical treatment response was assessed using the urticaria activity score summed over 7 days (UAS7) after the fourth, sixth, and 12th omalizumab injections.
Results
Twenty-six patients were enrolled in this study. The mean UAS7 at baseline was 16.9 (range, 4∼28). Treatment was completed in seven patients (26.9%). Three patients (11.5%) discontinued treatment because of poor treatment response. Symptoms improved in all patients at the fourth injection (UAS7=3.9, range 0∼10). The second administration of omalizumab showed that the lower the body mass index (BMI), the better the response to treatment (p＜0.05), and a similar trend after an additional injection.
Conclusion
The symptoms improved after omalizumab treatment in most patients. Those with a lower BMI and higher total immunoglobulin E levels during long-term treatment showed significantly better treatment responses.

Keyword

Body mass index; Hyperlipidemias; Obesity; Omalizumab; Urticaria