FCT 1-11 Treatment with omalizumab for cyclosporine- resistant chronic spontaneous urticaria = FCT 1-11 Treatment with omalizumab for cyclosporine- resistant chronic spontaneous urticaria

다국어 초록 (Multilingual Abstract)

Background: Cyclosporine is a strongly recommended in the third line treatment for chronic spontaneous urticaria (CSU) which is resistant to H1-antihistamine on EAACI/GA2LEN/EDF/WAO guideline. However, some CSU patients do not respond even to cyclosporine. Omalizumab, a humanized anti-immunoglobulin E antibody, is newly indicated for recalcitrant CSU. Objectives: To evaluate the effectiveness of omalizumab for cyclosporine-resistant CSU patients. Methods: Recalcitrant CSU patients who remained symptom despite cyclosporine 3 mg/kg/day and H1-antihistamine at up to four-fold increased dose were recruited at Pusan National University Yangsan Hospital from October 2014 to June 2016. Omalizumab was administrated 150mg by subcutaneous injection every 4 weeks. Effectiveness of omalizumab was assessed by seven-day urticaria activity score (UAS7) at 4 weeks after initial administration. Results: Eight patients (2 males, 6 females; average age 44.1years) were included in the study. All patients had moderate to severe symptom (mean UAS7 32.1, range 24-36) at baseline. At 4 weeks after 150mg omalizumab injection, no patient achieved complete response (UAS7 =0) and 2 patients (25.0%) were well-controlled state (UAS7 ≤6).2 patients (25.0%) had mild severity(7 ≤UAS7 ≤15) and 4 (50.0%) still had moderate symptoms (UAS7 ≥16). Conclusion: Omalizumab seems to have partial effect for CSU patient who did not respond to cyclosporine.