Kronik spontan ürtikerde omalizumab tedavisinin etkinliği: Retrospektif bir çalışma

Amaç: Bu çalışmada tedaviye dirençli kronik spontan ürtiker (KSÜ) nedeni ile omalizumab tedavisi kullanan hastaların klinik ve demografik özelliklerinin yanısıra omalizumab etkinliği ile yan etkilerinin geriye dönük olarak değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Kliniğimizde 2014-2017 yılları arasında H1-antihistaminiklere direnç nedeni ile 300 mg/ay subkutan omalizumab başlanan KSÜ hastalarının kayıtlı bilgisayar verileri taranarak retrospektif olarak incelendi. Hiç ürtikeryal plağı ve kaşıntısı olmayanlar tam yanıtlı, tedavi başlangıcına göre hayat kalitesi artan ve semptomlarında belirgin iyileşme olanlar kısmi yanıtlı, semptomlarında hiç iyileşme olmayanlar yanıtsız olarak kabul edildi. Bulgular: Tedaviye dirençli KSÜ nedeniyle omalizumab verilen 71 (41 K, 30 E) hasta çalışmaya dahil edildi. Bu hastaların ortalama hastalık süresi 54.6±52.9 (min-maks:8-360) ay olup, yaş ortalaması 43.6±16.4 (min-maks: 14-83) yıl idi. Omalizumab tedavisi 3. ayı sonunda hastaların yapılan değerlendirilmesinde, 14 (19.7%) hastada tam yanıt, 36 (50.7%) hastada kısmı yanıt görülürken, 21 (%29,6) hastada yanıt alınamadı. Başlangıç total IgE ve CRP düzeyleri, hastalık süresi, hasta yaşı, cinsiyeti, astım öyküsü ve immünsupresif kullanım öyküsü açısından 3. ay sonu omalizumab tedavisi yanıt grupları arasında herhangi bir istatistiksel farklılık tespit edilmedi (p>0.05). Hastalarda ciddi bir yan etki saptanmadı. Sonuç: Bu çalışmada, KSÜ nedeniyle takip edilip omalizumab kullanılan hastalarda, omalizumab tedavisinin etkin ve güvenilir olduğunu tespit ettik.

Anahtar Kelimeler:

Ürtiker, Omalizumab, İmmünoglobülin E

The efficacy of omalizumab therapy in chronic spontaneous urticaria: A retrospective analysis

Aim: In this study, it was aimed to evaluate the clinical and demographic features of patients using omalizumab therapy for treatment-resistant CSU, as well as the efficacy and side effects of omalizumab retrospectively. Material and Methods: In our clinic, we retrospectively checked the computer data of CSU patients who began subcutaneous omalizumab 300 mg / month due to H1-antihistamin resistance between 2014 and 2017. Those without urticaria plaque and itching were considered to be a complete response; those with improved quality of life relative to the onset of treatment and significant improvement in their symptoms were considered to be a partial response; and those with no improvement in symptoms were considered to be unresponsive. Results: Seventy-one (41 F, 30 M) patients who received omalizumab for treatment-resistant CSU were included in the study. The mean disease duration of these patients was 54.6 ± 52.9 (min-max: 8-360) months and the mean age was 43.6 ± 16.4 (min-max: 14-83) years. In patient evaluation at the end of the third month of treatment with omalizumab, 14 (19.7%) patients had complete response, 36 (50.7%) patients had partial response, whereas 21 (29.6 %) patients had no response. At the end of the 3rd month there was no statistical difference between the omalizumab treatment response groups in terms of baseline total IgE and CRP levels, disease duration, patient age, sex, history of asthma, and history of immunosuppressive use. There were no significant side effects in the patients. Conclusion: In this study, we found that treatment with omalizumab was effective and safe in patients who were being followed up due to CSU and used omalizumab.

Keywords:

omalizumab, urticaria, immunglobulin e,

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