| Summary: | 碩士 === 國立中正大學 === 生物醫學研究所 === 104 === Chronic Idiopathic urticaria (CIU), also known as chronic spontaneous urticaria (CSU), is defined by the presence of urticaria (hives), on most days of the week, for a period of six weeks or longer. About 40 percent of patients with CIU/CSU have accompanying episodes of angioedema. No external allergic cause or contributing disease process can be identified in 80 to 90 percent of adults and children with CIU/CSU. There are several theories regarding the pathogenesis of idiopathic chronic urticaria, none of which have been conclusively established. Up to 1 percent of the adult population develops CIU/CSU at some point in their lives. Adults are affected more often than children, and women are affected more often than men. The diagnosis of CIU/CSU is made clinically. Nonsedating H1-antihistamines are the current mainstay for initial treatment and are the only agents licensed for use in patients with chronic idiopathic urticaria. However, a majority of patients do not have a response to H1-antihistamines, even when the drugs are administered at three to four times their licensed dose.
It was a retrospective study to evaluate the efficacy and safety of subcutaneous omalizumab as add-on therapy for 24 weeks in 19 patients with CIU/CSU who remained symptomatic despite H1-antihistamines treatment at licensed doses. Patients aged 20-59 years with CIU/CSU were received subcutaneous omalizumab 300 mg every 4 weeks for 24 weeks.
Baseline UAS7 was approximately 36 in all CIU patients. UAS 7 of ≤ 6 in 94.73% (18/19 patients) after omalizumab therapy. The mean numbers of H1-antihistamine tablets that patients were taking as rescue medication was decreased. During the 24-week study period, one patient reported local reaction, one had angioedema, and one had bronchial asthma. No episodes of anaphylactic shock or death was reported during the study. Omalizumab diminished clinical symptoms and signs of CIU in patients who remained symptomatic despite the use of approved doses of H1-antihistamines.
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