It is never too late to treat chronic spontaneous urticaria with omalizumab: Real-life data from a multicenter observational study focusing on elderly patients
It is never too late to treat chronic spontaneous urticaria with omalizumab: Real-life data from a multicenter observational study focusing on elderly patients
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DOI：
10.1111/dth.14841
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发表时间：
2021-02-15
影响因子：
3.6
通讯作者：
Offidani, Annamaria
中科院分区：
文献类型：
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作者：
Martina, Emanuela;Damiani, Giovanni;Offidani, Annamaria
慢性自发性荨麻疹可能影响老年患者，严重影响其生活质量。老年患者的治疗管理具有挑战性；事实上，用于症状控制的一线推荐疗法是抗组胺药，但对于合并症和多种药物治疗方案的患者，抗组胺药可能会相互作用或增加副作用的风险。Omalizumab是首个被批准用于抗组胺药耐药的慢性自发性荨麻疹的生物药物。针对65岁以上接受奥玛珠单抗治疗的患者的真实数据很少。在我们的回顾性研究中，我们评估了这种生物疗法对65岁以上患者的疗效和安全性。为了评估omalizumab的疗效和缓解时间，我们进行了荨麻疹活动评分-7 （UAS-7）。我们收集了所有与治疗相关的不良事件。此外，我们调查了合并症的存在及其对omalizumab疗效的影响。纳入63例患者，平均年龄72.3±5.6岁，年龄范围：65-89岁。在63名受试者中，23名（36.5%）具有“早期完全缓解”特征，这意味着在治疗的前7天内达到UAS7评分为“0”。最常见的合并症是高血压，63例患者中有26例（41.3%）患有高血压；无不良事件报告。治疗效果与合并症之间无显著相关性。Omalizumab也是一种安全有效的治疗多种合并症的老年患者。
Chronic spontaneous urticaria might affect elderly patients, causing a serious impairment of their quality of life. The therapeutic management of the elderly patient is challenging; in fact, the first-line recommended therapy for symptom control are antihistamines, that may have interactions or increased risk of side effects in patients with comorbidities and poly-pharmacological regimen. Omalizumab is the first biological drug approved for chronic spontaneous urticaria resistant to antihistamines. Real-life data focusing on patients >65-year-old treated with omalizumab are rare. In our retrospective study, we evaluated the efficacy and safety of this biologic therapy in patients over 65-year-old. We performed Urticaria Activity Score-7 (UAS-7) in order to evaluate the efficacy of omalizumab and the time of remission. We collected any adverse event related to the treatment. Moreover, we investigated the presence of comorbidities and their impact on the efficacy of omalizumab. Sixty-threepatients, with a mean age of 72.3 +/- 5.6 years, range: 65-89) were enrolled. Of 63 subjects, 23 (36.5%) had an "early complete response" profile, which means the achievement of a UAS7 score of "0" within the first 7 days of therapy. The most frequent comorbidity was hypertension, which affected 26 of 63 (41.3%) patients; no adverse events were reported. No significant correlations were found between treatment effectiveness and comorbidities. Omalizumab is a safe and effective therapy also in elderly patients with multiple comorbidities.