Background

Omalizumab, a recombinant anti-IgE antibody, effectively treats chronic spontaneous urticaria. Evidence is lacking in patients with chronic inducible urticarias (CIndUs), which are frequently H₁-antihistamine resistant.

Objective

From the current published literature, we aimed to determine the strength of evidence for omalizumab efficacy and safety in the treatment of CIndUs.

Methods

We performed a PubMed search to identify evidence on omalizumab use in the following 9 CIndU subtypes: symptomatic dermographism, cold urticaria, delayed-pressure urticaria, solar urticaria, heat urticaria, vibratory angioedema, cholinergic urticaria, contact urticaria, and aquagenic urticaria.

Results

Forty-three trials, case studies, case reports, and analyses were identified. Our review indicates that omalizumab has substantial benefits in patients with various CIndUs. The evidence is strongest for symptomatic dermographism, cold urticaria, and solar urticaria. Little/no evidence was available on vibratory angioedema and aquagenic and contact urticaria. Our review supports rapid onset of action demonstrated through early symptom control in most cases, sometimes within 24 hours. Many patients gained complete/partial symptom relief and substantially improved quality of life. Adverse events were generally low, with omalizumab being well tolerated by most patients, including children.

Conclusions

A strong body of evidence supports the use of omalizumab in the treatment of patients with therapy-refractory CIndU. More data from randomized controlled studies are warranted.

中文翻译：

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奥马珠单抗治疗慢性荨麻疹的患者：已发表证据的系统评价

背景

重组抗IgE抗体Omalizumab有效治疗慢性自发性荨麻疹。缺乏对慢性诱导性荨麻疹（CIndUs）患者的证据，这些患者经常对H _1-抗组胺药有抵抗力。

客观的

从当前发表的文献中，我们旨在确定奥马珠单抗治疗CIndUs的有效性和安全性的证据强度。

方法

我们进行了PubMed搜索，以鉴定在以下9种CIndU亚型中使用奥马珠单抗的证据：症状性皮肤病，冷荨麻疹，延迟性荨麻疹，太阳性荨麻疹，热荨麻疹，振动性血管性水肿，胆碱能性荨麻疹，接触性荨麻疹和水生性荨麻疹。

结果

确定了43项试验，案例研究，案例报告和分析。我们的评价表明，奥马珠单抗对各种CIndUs患者具有实质性益处。症状性皮肤病，冷荨麻疹和日光性荨麻疹的证据最充分。关于振动性血管性水肿，水生性和接触性荨麻疹的证据很少/没有证据。我们的评论支持在大多数情况下（有时在24小时内）通过早期症状控制证明快速起效。许多患者获得了完全/部分症状缓解，生活质量大大提高。不良事件一般很少，大多数患者，包括儿童，对奥马珠单抗的耐受性良好。

结论

强有力的证据支持使用奥马珠单抗治疗难治性CIndU患者。有必要从随机对照研究中获得更多数据。