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Vol. 154, No. 2, 2011
Issue release date: January 2011

Anti-Immunoglobulin E Treatment of Patients with Recalcitrant Physical Urticaria

Metz M. · Altrichter S. · Ardelean E. · Keβler B. · Krause K. · Magerl M. · Siebenhaar F. · Weller K. · Zuberbier T. · Maurer M.
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Abstract

In physical urticaria, exogenous physical factors such as thermal triggers, solar radiation and mechanic triggers including friction or pressure are responsible for the elicitation of symptoms in the skin of patients. Avoidance of the respective stimulus is usually difficult or impossible, and many patients are not sufficiently treated with standard antihistamines. We report that treatment with omalizumab (Xolair®) of 7 patients with physical urticarias [solar urticaria (n = 2), urticaria factitia/symptomatic dermographism (n = 2), cold urticaria, delayed pressure urticaria and localized heat urticaria] resulted in complete symptom control within days after the first injection in 5 patients. In 1 patient, symptoms improved after increasing the dose of omalizumab, and 1 patient with localized heat urticaria did not respond significantly to treatment. Before anti-immunoglobulin E treatment, all patients had suffered from their physical urticaria for years and had had numerous unsuccessful therapies. The overall excellent responses to omalizumab treatment reported here indicate that anti-immunoglobulin E is a safe and effective treatment for recalcitrant physical urticarias.



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References

  1. Magerl M, Borzova E, Gimenez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, Metz M, Mlynek A, Maurer M: The definition and diagnostic testing of physical and cholinergic urticarias – EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy 2009;64:1715–1721.
  2. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Gimenez-Arnau A, Grattan CE, Kapp A, Merk HF, Rogala B, Saini S, Sanchez-Borges M, Schmid-Grendelmeier P, Schunemann H, Staubach P, Vena GA, Wedi B, Maurer M: EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64:1417–1426.
  3. Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Gimenez-Arnau AM, Grattan CE, Kapp A, Maurer M, Merk HF, Rogala B, Saini S, Sanchez-Borges M, Schmid-Grendelmeier P, Schunemann H, Staubach P, Vena GA, Wedi B: EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy 2009;64:1427–1443.
  4. Grabbe J: Pathomechanisms in physical urticaria. J Investig Dermatol Symp Proc 2001;6:135–136.
  5. Hughes R, Cusack C, Murphy GM, Kirby B: Solar urticaria successfully treated with intravenous immunoglobulin. Clin Exp Dermatol 2009;34:e660–e662.
  6. Chang TW, Shiung YY: Anti-IgE as a mast cell-stabilizing therapeutic agent. J Allergy Clin Immunol 2006;117:1203–1212.
  7. Boyce JA: Successful treatment of cold-induced urticaria/anaphylaxis with anti-IgE. J Allergy Clin Immunol 2006;117:1415–1418.
  8. Güzelbey O, Ardelean E, Magerl M, Zuberbier T, Maurer M, Metz M: Successful treatment of solar urticaria with anti-immunoglobulin E therapy. Allergy 2008;63:1563– 1565.
  9. Bindslev-Jensen C, Skov PS: Efficacy of omalizumab in delayed pressure urticaria: a case report. Allergy 2010;65:138–139.
  10. Bullerkotte U, Wieczorek D, Kapp A, Wedi B: Effective treatment of refractory severe heat urticaria with omalizumab. Allergy 2009, Epub ahead of print.
  11. Metz M, Bergmann P, Zuberbier T, Maurer M: Successful treatment of cholinergic urticaria with anti-immunoglobulin E therapy. Allergy 2008;63:247–249.
  12. Magerl M, Schmolke J, Metz M, Zuberbier T, Siebenhaar F, Maurer M: Prevention of signs and symptoms of dermographic urticaria by single-dose ebastine 20 mg. Clin Exp Dermatol 2009;34:e137–e140.
  13. Metz M, Scholz E, Ferran M, Izquierdo I, Gimenez-Arnau A, Maurer M: Rupatadine and its effects on symptom control, stimulation time, and temperature thresholds in patients with acquired cold urticaria. Ann Allergy Asthma Immunol 2010;104:86–92.
  14. Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M: High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J Allergy Clin Immunol 2009;123:672–679.
  15. Kaplan AP, Joseph K, Maykut RJ, Geba GP, Zeldin RK: Treatment of chronic autoimmune urticaria with omalizumab. J Allergy Clin Immunol 2008;122:569–573.
  16. Romano C, Sellitto A, De Fanis U, Esposito G, Arbo P, Giunta R, Lucivero G: Maintenance of remission with low-dose omalizumab in long-lasting, refractory chronic urticaria. Ann Allergy Asthma Immunol 2010;104:95–97.
  17. Spector SL, Tan RA: Effect of omalizumab on patients with chronic urticaria. Ann Allergy Asthma Immunol 2007;99:190–193.


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