Omalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: Can we define better-responding endotypes?

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dc.authorid0000-0002-7022-913X
dc.contributor.authorKocatürk, Emek
dc.contributor.authorBülbül Başkan, Emel
dc.contributor.authorKüçük, Özlem Su
dc.contributor.authorÖzdemir, Mustafa
dc.contributor.authorÖrnek, Sinem
dc.contributor.authorCan, Pelin Kuteyla
dc.contributor.authorHaşal, Eda
dc.contributor.authorEngin, Burhan
dc.contributor.authorAtakan, Nilgün
dc.contributor.authorAlpsoy, Erkan
dc.date.accessioned2022-11-24T13:02:07Z
dc.date.available2022-11-24T13:02:07Z
dc.date.issued2022
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Deri ve Zührevi Hastalıklar Ana Bilim Dalı
dc.description.abstractBackground: Chronic Spontaneous Urticaria (CSU) is characterized by recurrent wheals and/or angioedema for longer than 6-weeks. Guidelines recommend Omalizumab (Oma) as first-line and Cyclosporine-A (Cs-A) as second-line treatment in antihistamine resistant CSU. This step-wise algorithm might be time-consuming and costly. Objective: To determine indicators of response to Oma or Cs-A in CSU patients. Methods: We retrospectively analyzed data from seven centers in Turkey; the inclusion criteria for patients were to receive both Oma and Cs-A treatment (not concurrently) at some point in time during their follow-up. Clinical and laboratory features were compared between groups. Results: Among 110 CSU patients; 47 (42.7%) were Oma-responders, 15 (13.6%) were Cs-A-responders, and 24 (21.8%) were both Oma and Cs-A responders and 24 (21.8%) were non-responders to either drug. High CRP levels were more frequent in Cs-A-responders (72.7% vs. 40.3%; p = 0.055). Oma-responders had higher baseline UCT (Urticaria Control Test) scores (6 vs. 4.5; p = 0.045). Responders to both drugs had less angioedema and higher baseline UCT scores compared to other groups (33.3% vs. 62.8%; p = 0.01 and 8 vs. 5; p = 0.017). Non-responders to both drugs had an increased frequency in the female gender and lower baseline UCT scores compared to other groups (87.5% vs. 61.6%; p = 0.017 and 5 vs. 7; p = 0.06). Study Limitations: Retrospective nature, limited number of patients, no control group, the lack of the basophil activation (BAT) or BHRA (basophil histamine release assay) tests. Conclusions: Baseline disease activity assessment, which considers the presence of angioedema and disease activity scores, gender, and CRP levels might be helpful to predict treatment outcomes in CSU patients and to choose the right treatment for each patient. Categorizing patients into particular endotypes could provide treatment optimization and increase treatment success.
dc.identifier.citationKocatürk, E., Bülbül Başkan, E., Küçük, Ö. S., Özdemir, M., Örnek, S., Can, P. K. ... Alpsoy, E. (2022). Omalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: Can we define better-responding endotypes? Anais Brasileiros de Dermatologia, 97(5), 592-600. https://doi.org/10.1016/j.abd.2022.03.003
dc.identifier.doi10.1016/j.abd.2022.03.003
dc.identifier.endpage600
dc.identifier.issn0365-0596
dc.identifier.issn1806-4841
dc.identifier.issue5
dc.identifier.pmid35853771
dc.identifier.scopus2-s2.0-85134262805
dc.identifier.scopusqualityQ3
dc.identifier.startpage592
dc.identifier.urihttps://doi.org/10.1016/j.abd.2022.03.003
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10026
dc.identifier.volume97
dc.identifier.wos000882887400005en_US
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÖzdemir, Mustafa
dc.language.isoen
dc.publisherElsevier Science Inc
dc.relation.ispartofAnais Brasileiros de Dermatologiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectBiomarker
dc.subjectChronic Urticaria
dc.subjectCyclosporine
dc.subjectOmalizumab
dc.titleOmalizumab versus cyclosporin-A for the treatment of chronic spontaneous urticaria: Can we define better-responding endotypes?
dc.typeArticle

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