Biomarkers of response to omalizumab in patients with chronic spontaneous urticaria
Allergologia et Immunopathologia, cilt.53, sa.4, ss.7-13, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 53 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.15586/aei.v53i4.1343
- Dergi Adı: Allergologia et Immunopathologia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, DIALNET
- Sayfa Sayıları: ss.7-13
- Anahtar Kelimeler: chronic spontaneous urticaria, immunoglobulin E, omalizumab, urticaria activity score
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Background and Objectives: Managing chronic spontaneous urticaria (CSU) resistant to anti-histamines remains challenging, and predictors of omalizumab efficacy are not fully understood. This study evaluated omalizumab’s effectiveness, response patterns, and predictors in CSU patients. Materials and Methods: A retrospective analysis was conducted on 72 patients receiving omalizumab for at least six months. Factors influencing response to anti-IgE therapy were examined. Results: Among the 72 patients with chronic spontaneous urticaria (CSU), 86.1% responded to omalizumab: 58.3% had a good response (UAS-7 <6), 27.8% showed a partial response, and 13.9% were non-responders. Baseline total IgE levels were significantly higher in responders compared to non-responders (good: 291.4 kUA/L vs. 60.2 kUA/L, p = 0.003; partial: 148 kUA/L vs. 60.2 kUA/L, p = 0.049). ROC analysis identified a total IgE cut-off of 64 kUA/L for predicting omalizumab response (AUC: 0.67, p = 0.019; sensitivity: 82%, specificity: 48%). Non-responders had significantly higher erythrocyte sedimentation rates (20.0 mm/h vs. 8.25 mm/h, p = 0.018). Patients with recurrence post-treatment had elevated thyroid-stimulating hormone (TSH) and C-reactive protein (CRP) levels (p = 0.006, p = 0.007). Among responders, 29% had an early response and 71% a late response. Early responders had significantly lower anti-thyroglobulin (anti-TG) and antinuclear antibody (ANA) positivity (p = 0.036, p = 0.035). Systemic inflammatory indices (SII, SIRI) did not predict response. Conclusions: Baseline total IgE may predict omalizumab response, while ANA and anti-TG positivity correlate with delayed response. Elevated TSH and CRP levels may indicate a higher recurrence risk after treatment discontinuation.