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Endotype-based patient classification may be useful for predicting treatment outcomes and for selecting appropriate treatment options for chronic spontaneous urticaria.
In a subpopulation of patients with chronic spontaneous urticaria who received both Omalizumab (monoclonal antibody) and Cyclosporine-A at any point during their follow-up, the majority (40%) responded to Omalizumab, another 20% responded to both Omalizumab and Cyclosporine-A, the minority (10%) responded to Cyclosporine-A, and 20% did not respond to either medication, according to a study published in "Anais Brasileiros de Dermatologia".
In people suffering from urticaria, Emek Kocatürk et al. sought to identify markers of response to Cyclosporine-A or Omalizumab. Retrospective analysis of data was done. The patients should have received both Omalizumab and Cyclosporine-A medication (not concurrently) at some point during their follow-up in order to be included in the analysis of the data. Each group's laboratory and clinical characteristics were contrasted.
Overall, 110 antihistamine-refractory subjects with chronic spontaneous urticaria were segregated into Omalizumab -responders (n = 47, 42.7%), Cyclosporine-A-responders (n = 15, 13.6%), both Cyclosporine-A and Omalizumab responders (n = 24, 21.8%), and non-responders to either medication (n = 24, 21.8%). Cyclosporine-A responders had levels of high C-reactive protein (CRP, 72.7% vs. 40.3%).
Urticaria Control Test (UCT) baseline scores were higher in omalizumab-responders (6 vs. 4.5).
In contrast with other groups, responders to both medications had higher baseline UCT scores (8 vs. 53) and lower angioedema (33.3% vs. 62.8%). In comparison to other groups, non-responders to both medicines had lower baseline UCT scores (5 vs. 7) and were more likely to be female (87.5% vs. 61.6%).
In order to predict treatment outcomes in subjects with chronic spontaneous urticaria and to determine the suitable intervention option for each patient, baseline disease activity assessment, which takes into account the CRP levels, gender, presence of angioedema and disease activity scores may be useful. Improved treatment success and treatment optimization can be provided to patients if they are divided into certain endotypes.
Anais Brasileiros de Dermatologia
Omalizumab versus Cyclosporin-A for the treatment of chronic spontaneous urticaria: can we define better-responding endotypes?
Emek Kocatürk et al.
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