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Commentaries
An Algorithm to Guide the Rational, Evidence-Based Use of Omalizumab in the Treatment of Chronic Urticaria
Aproximación a un uso racional y reglado de omalizumab en la urticaria crónica
R. Ruiz-Villaverde
Unidad de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Omalizumab is a monoclonal anti-IgE antibody currently used in the treatment of chronic spontaneous urticaria &#40;CSU&#41; as a third-line option in cases refractory to treatment with the licensed dose of the first-line treatment or up to 4 times that dose&#46; The introduction of omalizumab into the therapeutic arsenal for CSU brought about a real revolution in the management of this condition&#46; However&#44; the dose recommended in the Summary of Product Characteristics&#8212;based on the results of pivotal studies carried out as part of the approval process&#8212;is 300&#160;mg&#47;mo for a period of up to 6 months&#46; In the present issue&#44; the Catalan-Balearic working group presents a treatment algorithm to guide the use of omalizumab in the management of CSU&#46; They discuss the various aspects of management related to the rational and evidence-based use of this drug&#44; including candidate population&#44; monitoring tools &#40;Urticaria Activity Score 7 &#91;UAS7&#93; and Urticarial Control Test &#91;UCT&#93;&#41;&#44; starting dose and dose adjustment as well as the definition of response and response time&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In a novel approach&#44; the authors of the algorithm propose the use of an increased dose of 450 or 600&#160;mg every 4 weeks if the licensed doses do not achieve adequate control of disease activity&#8212;defined as a UAS7 of 6 or less&#46; A study by the Catalan workgroup showed that 21&#37; of patients require the increased dose to achieve a UAS7 of 6 or less and that 7&#37; did not achieve disease control even with the higher dose&#46; The predictors of partial response to 300&#160;mg and the need for higher doses included prior treatment with ciclosporin&#44; obesity&#44; and age under 57 years&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This algorithm is of particular interest to dermatologists working in clinical practice&#46;</p></span>"
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Article information
ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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