Commentaries
A Sea Change in the Treatment of Chronic Urticaria
Quién lo ha visto y quién lo ve? Tratando la urticaria crónica
A.M. Giménez-Arnau
Servicio de Dermatología, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain
Read
3414
Timeswas read the article
1424
Total PDF
1990
Total HTML
Share statistics
array:23 [ "pii" => "S1578219019301064" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.11.021" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "2115" "copyrightAnyo" => "2019" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2019;110:260" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3 "HTML" => 3 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0001731018305337" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.11.003" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "2115" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2019;110:260" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 327 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 210 "PDF" => 116 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comentarios Editoriales</span>" "titulo" => "Quién lo ha visto y quién lo ve? Tratando la urticaria crónica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "260" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "A Sea Change in the Treatment of Chronic Urticaria" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.M. Giménez-Arnau" "autores" => array:1 [ 0 => array:2 [ "nombre" => "A.M." "apellidos" => "Giménez-Arnau" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219019301064" "doi" => "10.1016/j.adengl.2018.11.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019301064?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018305337?idApp=UINPBA000044" "url" => "/00017310/0000011000000004/v2_201905040606/S0001731018305337/v2_201905040606/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S157821901930143X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.03.018" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "2198" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2019;110:261" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Commentaries</span>" "titulo" => "Hidradenitis Suppurativa: Need for Early Diagnosis and Management of the Disease and Associated Conditions" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "261" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hidradenitis Supurativa: Necesidad de Un Diagnóstico e Intervención Precoz Sobre La Enfermedad y Sus Comorbilidades" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G Roustan" "autores" => array:1 [ 0 => array:2 [ "nombre" => "G" "apellidos" => "Roustan" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101930064X" "doi" => "10.1016/j.ad.2019.01.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173101930064X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901930143X?idApp=UINPBA000044" "url" => "/15782190/0000011000000004/v1_201905070820/S157821901930143X/v1_201905070820/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219019300873" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.12.010" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "2129" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2019;110:259" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9 "formatos" => array:2 [ "HTML" => 7 "PDF" => 2 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Commentaries</span>" "titulo" => "Hidradenitis Suppurativa as a Systemic Disease: Association With Metabolic Syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "259" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La hidradenitis supurativa como enfermedad sistémica: asociación a síndrome metabólico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Martorell" "autores" => array:1 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Martorell" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101830574X" "doi" => "10.1016/j.ad.2018.12.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173101830574X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300873?idApp=UINPBA000044" "url" => "/15782190/0000011000000004/v1_201905070820/S1578219019300873/v1_201905070820/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Commentaries</span>" "titulo" => "A Sea Change in the Treatment of Chronic Urticaria" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "260" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "A.M. Giménez-Arnau" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A.M." "apellidos" => "Giménez-Arnau" "email" => array:1 [ 0 => "anamariagimenezarnau@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital del Mar, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Quién lo ha visto y quién lo ve? Tratando la urticaria crónica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic urticaria is primarily an autoimmune disease, mediated either by immunoglobulin (Ig) E or IgG, acting on the high-affinity IgE receptor (FcɛIgERI), which is overexpressed both in skin mastocytes and circulating basophils. Different exacerbating factors contribute to the manifestation of the condition as well as its conversion to a chronic process. Regardless of whether the spontaneous or inducible type of disease is present, the chosen therapy should be effective and safe, and it needs to be maintained for long periods of between 1 to 5 years. The therapeutic goal is to keep the patient completely free of symptoms so that she or he can lead a normal life. With this aim, omalizumab has become an essential addition to the therapeutic armamentarium for the treatment of chronic urticaria. The authors of the commented article reflect on their experience with the use of this monoclonal antibody in daily clinical practice in accordance with the recommendations of the most recent treatment guidelines.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> In daily clinical practice, their patients achieve better therapeutic outcomes than in clinical trials, measured in terms of the urticaria activity score (UAS) in the 7 days before the study visit. Only 1 phase II study, EXCUISITE, reports percentages of complete control similar to those observed in clinical practice. That study only included patients with IgE anti-peroxidase; that is, patients were selected for an FcɛIgERI activation mechanism or autoallergy. This suggest that this type I autoimmunity mechanism is the predominant one. In contrast, IgG anti-FcɛIgERI, implicated in type 2<span class="elsevierStyleHsp" style=""></span>b autoimmunity mechanism, is less frequent. The authors of the commented article analyzed clinical response and complete response at 3 and 6 months of treatment and found higher percentages of responders than those reported in the clinical trials. To define predictors of response, they link later complete response with those patients with longer-standing urticaria (≥<span class="elsevierStyleHsp" style=""></span>18 months), who are perhaps the most refractory patients. The article does not discuss studies that suggested that this group of patients might be affected by type IIb autoimmunity as indicated by a positive autologous serous skin test (ASST) or positivity for functional serum autoantibodies. The authors report agreement with previous studies such as the study by Curto-Barredo et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> that the slowest response to omalizumab can also be linked to the use immediately beforehand of immunosuppressive medication, such as ciclosporin A. This was the observation of the authors of the Xarxa d’Urticària Catalana i Balear (XUrCB) in a cohort of 286 patients in a bivariate analysis. To finish, we would like to congratulate the authors on the efforts to systematize their experience in the management of chronic urticaria using omalizumab. This is the only way to properly evaluate our day-to-day work.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Giménez-Arnau A. Quién lo ha visto y quién lo ve? Tratando la urticaria crónica. Actas Dermosifiliogr. 2019;110:260.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La efectividad del tratamiento con omalizumab en la vida real es menor en pacientes con urticaria crónica de más de 18 meses de evolución y tratamiento inmunosupresor previo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "X. Cubiró" 1 => "J. Spertino" 2 => "E. Rozas-Muñoz" 3 => "E. Serra-Baldrich" 4 => "L. Puig" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2018.09.009" "Revista" => array:2 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2018" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Omalizumab updosing allows disease activity control in refractory patients with chronic spontaneous urticaria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Curto-Barredo" 1 => "J. Spertino" 2 => "I. Figueras-Nart" 3 => "V. Expósito-Serrano" 4 => "A. Guilabert" 5 => "G. Melé-Ninot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.16379" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2018" "volumen" => "179" "paginaInicial" => "210" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29368377" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000004/v1_201905070820/S1578219019301064/v1_201905070820/en/main.assets" "Apartado" => array:4 [ "identificador" => "66476" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Commentaries" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011000000004/v1_201905070820/S1578219019301064/v1_201905070820/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019301064?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 6 | 12 |
| 2024 October | 56 | 44 | 100 |
| 2024 September | 62 | 23 | 85 |
| 2024 August | 88 | 60 | 148 |
| 2024 July | 59 | 33 | 92 |
| 2024 June | 72 | 32 | 104 |
| 2024 May | 60 | 36 | 96 |
| 2024 April | 61 | 18 | 79 |
| 2024 March | 57 | 30 | 87 |
| 2024 February | 51 | 30 | 81 |
| 2024 January | 51 | 37 | 88 |
| 2023 December | 46 | 19 | 65 |
| 2023 November | 74 | 26 | 100 |
| 2023 October | 51 | 21 | 72 |
| 2023 September | 30 | 28 | 58 |
| 2023 August | 24 | 16 | 40 |
| 2023 July | 26 | 32 | 58 |
| 2023 June | 39 | 20 | 59 |
| 2023 May | 28 | 19 | 47 |
| 2023 April | 22 | 17 | 39 |
| 2023 March | 20 | 22 | 42 |
| 2023 February | 30 | 26 | 56 |
| 2023 January | 28 | 27 | 55 |
| 2022 December | 25 | 34 | 59 |
| 2022 November | 21 | 19 | 40 |
| 2022 October | 26 | 17 | 43 |
| 2022 September | 21 | 37 | 58 |
| 2022 August | 23 | 39 | 62 |
| 2022 July | 19 | 41 | 60 |
| 2022 June | 24 | 28 | 52 |
| 2022 May | 29 | 31 | 60 |
| 2022 April | 32 | 25 | 57 |
| 2022 March | 35 | 39 | 74 |
| 2022 February | 23 | 20 | 43 |
| 2022 January | 27 | 35 | 62 |
| 2021 December | 31 | 36 | 67 |
| 2021 November | 25 | 39 | 64 |
| 2021 October | 36 | 51 | 87 |
| 2021 September | 18 | 30 | 48 |
| 2021 August | 23 | 25 | 48 |
| 2021 July | 15 | 18 | 33 |
| 2021 June | 16 | 18 | 34 |
| 2021 May | 33 | 35 | 68 |
| 2021 April | 65 | 22 | 87 |
| 2021 March | 76 | 20 | 96 |
| 2021 February | 68 | 23 | 91 |
| 2021 January | 42 | 16 | 58 |
| 2020 December | 39 | 10 | 49 |
| 2020 November | 10 | 15 | 25 |
| 2020 October | 13 | 6 | 19 |
| 2020 September | 19 | 8 | 27 |
| 2020 August | 21 | 11 | 32 |
| 2020 July | 27 | 9 | 36 |
| 2020 June | 21 | 20 | 41 |
| 2020 May | 10 | 7 | 17 |
| 2020 April | 19 | 7 | 26 |
| 2020 March | 11 | 11 | 22 |
| 2020 February | 3 | 0 | 3 |
| 2019 May | 3 | 0 | 3 |
Show all
