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Predicting responses to omalizumab in antihistamine-refractory chronic urticaria: A real-world longitudinal study

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dc.contributor.authorLee, HY-
dc.contributor.authorJeon, HS-
dc.contributor.authorJang, JH-
dc.contributor.authorLee, Y-
dc.contributor.authorShin, YS-
dc.contributor.authorNahm, DH-
dc.contributor.authorPark, HS-
dc.contributor.authorYe, YM-
dc.date.accessioned2024-06-19T07:07:05Z-
dc.date.available2024-06-19T07:07:05Z-
dc.date.issued2024-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/32541-
dc.description.abstractBackground: Treating chronic urticaria (CU) that is unresponsive to H1-antihistamines (H1AHs) is challenging, and the real-world effectiveness of omalizumab remains unclear. Objective: Our aim was to evaluate the real-world effectiveness of omalizumab, optimal response assessment timing, and predictive factors. Methods: Initially, 5535 patients with CU who were receiving at least 20 mg of loratadine daily for at least 6 months (January 2007-August 2021) were screened. Ultimately, 386 patients who had been receiving omalizumab add-on treatment for >6 months were followed-up for more than 2 years. Predictors of treatment response to omalizumab add-on therapy for patients with antihistamine-refractory CU were identified by using a generalized linear model. Results: In our retrospective cohort, omalizumab treatment showed cumulative response rates of 55.2% at 3 months, 71.0% at 6 months, and 81.4% at 9 months for patients with H1AH-refractory CU. Analysis of longitudinal responses to omalizumab treatment revealed 3 distinct clusters: favorable (cluster 1 [n = 158]), intermediate (cluster 2 [n =1 43]), and poor responses (cluster 3 [n = 85]). Subjects were categorized on the basis of whether they had achieved a complete response within 3 months; 213 early responders, 117 late responders, and 56 nonresponders were identified. The initial dose of omalizumab differed significantly among the 3 clusters. Low total IgE level (<40 kU/L) predicted nonresponse (odds ratio [OR] = 3.10 [P = .018]). Early responders were associated with a higher initial omalizumab dose (≥300 mg) (OR = 2.07 [P = .016]), higher basophil counts (OR = 2.0 [P = .014]), total IgE levels exceeding 798 kU/L (OR = 0.37 [P = .047]), and lower platelet-to-lymphocyte ratio (OR = 0.50 [P = .050]). Conclusion: Real-world data reveal 3 distinct clusters for response to omalizumab treatment; confirm low serum total IgE level (<40 kU/L) as a predictor of nonresponse; and identify potential biomarkers, including IgE level, basophil count, and PLR, for early responders.-
dc.language.isoen-
dc.titlePredicting responses to omalizumab in antihistamine-refractory chronic urticaria: A real-world longitudinal study-
dc.typeArticle-
dc.identifier.pmid38577481-
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992700-
dc.subject.keywordChronic urticaria-
dc.subject.keywordomalizumab-
dc.subject.keywordpredictor-
dc.subject.keywordtotal IgE-
dc.subject.keywordtreatment response-
dc.contributor.affiliatedAuthorJang, JH-
dc.contributor.affiliatedAuthorLee, Y-
dc.contributor.affiliatedAuthorShin, YS-
dc.contributor.affiliatedAuthorNahm, DH-
dc.contributor.affiliatedAuthorPark, HS-
dc.contributor.affiliatedAuthorYe, YM-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.jacig.2024.100245-
dc.citation.titleThe journal of allergy and clinical immunology. Global-
dc.citation.volume3-
dc.citation.number2-
dc.citation.date2024-
dc.citation.startPage100245-
dc.citation.endPage100245-
dc.identifier.bibliographicCitationThe journal of allergy and clinical immunology. Global, 3(2). : 100245-100245, 2024-
dc.identifier.eissn2772-8293-
dc.relation.journalidJ027728293-
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Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
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