Purpose of the Review Omalizumab has become the mainstay of the treatment of severe CSU, but a subset of patients seems completely unresponsive to the drug. This review tried to understand the reasons for this different behavior. Recent Findings Growing evidence shows that IgE-mediated autoimmunity to an array of autoallergens is common in CSU, while IgG-mediated autoimmunity to IgE or to the highaffinity IgE receptor, which has been known for many years, seems to be involved in a minority of patients. This may explain the different responsiveness to anti-IgE therapy. Summary CSU is probably an autoimmune disease in most cases. Patients with an IgEmediated disease (autoallergy) seem those who respond to omalizumab, whereas those with an IgG-mediated autoimmune disease appear to respond slowly or are unresponsive to the drug and are candidates to the immunosuppressive treatments, like cyclosporine.

Unresponsiveness to Omalizumab in Chronic Spontaneous Urticaria / R. Asero, A.V. Marzano, M. Cugno. - In: CURRENT TREATMENT OPTIONS IN ALLERGY. - ISSN 2196-3053. - 7:2(2020 Mar), pp. 135-141.

Unresponsiveness to Omalizumab in Chronic Spontaneous Urticaria

A.V. Marzano;M. Cugno
2020

Abstract

Purpose of the Review Omalizumab has become the mainstay of the treatment of severe CSU, but a subset of patients seems completely unresponsive to the drug. This review tried to understand the reasons for this different behavior. Recent Findings Growing evidence shows that IgE-mediated autoimmunity to an array of autoallergens is common in CSU, while IgG-mediated autoimmunity to IgE or to the highaffinity IgE receptor, which has been known for many years, seems to be involved in a minority of patients. This may explain the different responsiveness to anti-IgE therapy. Summary CSU is probably an autoimmune disease in most cases. Patients with an IgEmediated disease (autoallergy) seem those who respond to omalizumab, whereas those with an IgG-mediated autoimmune disease appear to respond slowly or are unresponsive to the drug and are candidates to the immunosuppressive treatments, like cyclosporine.
Chronic urticaria; Biologics; Omalizumab; Anti-IgE
Settore MED/09 - Medicina Interna
mar-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/784012
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