The use of an urticaria control test for the evaluation of omalizumab treatment response in patients diagnosed with chronic urticaria

Background and Design: Urticaria is a very common skin disease which is characterized by itchy, erythematous and edematous plaques. Angioedema can also be seen in half of the cases in addition to skin findings. In most cases of chronic urticaria, the underlying factor is not known. Omalizumab, a recombinant human monoclonal immunoglobulin G (IgG) antibody against IgE, is a safe treatment option in chronic urticaria cases which are resistant to treatment with antihistamines. This study aimed to evaluate the treatment responses of chronic urticaria patients taking omalizumab treatment with an urticaria control test (UCT).
Materials and Methods: One hundred fifty-four patients diagnosed with chronic urticaria taking omalizumab treatment attended our evaluation between January 1, 2017 and December 31, 2018. These patients were evaluated with an UCT every four weeks. Sixty-six patients who were evaluated with an UCT during the course of the following 12 weeks were statistically analyzed. Thirty-nine of the patients received a treatment shorter than 12 months (the first group), and the remaining 27 patients received treatment for longer than 12 months (the second group). The patients were analyzed according to the duration of their treatment.
Results: The first, second, and third average UCT scores of the 3 sequential applications for the first group were 9.16; 11.57; and 12.73; respectively. There was a statistically significant difference in the UCT scores between the 3 successive applications in the first group (p<0.05). On the other hand, the first, second, and third average UCT scores of the 3 sequential applications for the the second group were 11.20; 11.40; and 12.36 respectively. There was statistically significant difference in the UCT scores between the 3 successive applications for the second group.
Conclusion: The effectiveness of omalizumab treatment in chronic urticaria patients with an UCT was investigated in this study. Omalizumab proved to be an effective treatment option in chronic urticaria patients.

Keywords: Chronic urticaria, omalizumab, urticaria control test

Kronik ürtiker hastalar?nda omalizumab tedavi yan?t?n?n de?erlendirilmesinde ürtiker kontrol testi kullan?m?

Amaç: Ürtiker toplumda oldukça s?k görülen ka??nt?l? eritemli ve ödemli plaklarla karakterize bir deri hastal???d?r. Deri bulgular?n?n yan?nda olgular?n yar?s?na anjiyoödem de e?lik edebilmektedir. Etiyolojisine bak?ld???nda çe?itli tetikleyici faktörlerin rol alabilece?i dü?ünülse de özellikle kronik olgularda altta yatan sebep belirsizdir. Omalizumab immünoglobülin E’ye (IgE) kar?? geli?tirilmi? rekombinan insan monoklonal IgG antikoru olup yüksek doz antihistaminik tedavisine dirençli kronik spontan ürtiker olgular?nda güvenilir bir tedavi seçene?idir. Bu çal??mada kronik spontan ürtiker tan?l? antihistaminik tedavisine dirençli omalizumab tedavisi almakta olan hastalar?n tedavi yan?tlar?n?n ürtiker kontrol testi (ÜKT) ile de?erlendirilmesi amaçlanmaktad?r.
Gereç ve Yöntem: Çal??mam?za 1 Ocak 2017-1 ?ubat 2018 tarihleri aras?nda, fakültemiz deri ve zührevi hastal?klar anabilim dal?nda omalizumab tedavisi ba?lanm?? kronik ürtiker tan?l? 154 hasta kat?ld?. Bu hastalar 4 haftada bir ÜKT’ye tabi tutuldu. Birbirini takip eden 12 hafta boyunca ÜKT’yi dolduran 66 hasta istatistiksel analize al?nd?. Hastalar?n 39’u 12 aydan k?sa süreli, 27’si 12 aydan uzun süredir tedavi alan hastalardan olu?maktayd?. Ürtiker kontrol testi toplam skorlar? ve her bir soru için takip eden 3 uygulama aras?nda anlaml? bir fark olup olmad???, varsa hangi uygulamalar aras?nda oldu?u ara?t?r?ld?.
Bulgular: On iki ay öncesi grubun takip eden 3 uygulamadan ilk uygulama ortalamas? 9,16, ikinci uygulama ortalamas? 11,57 ve üçüncü uygulama ortalamas? 12,73’tü. Takip eden 3 uygulama ÜKT skorlar? aras?nda anlaml? bir fark mevcuttu. 12 ay ve sonras? grubunun takip eden 3 uygulamadan ilk uygulama skoru ortalamas? 11,20, ikinci uygulama ortalama skoru 11,40 ve üçüncü uygulama ortalama skoru 12.36 idi. Takip eden 3 uygulama ÜKT skorlar? aras?nda anlaml? bir fark mevcuttu.
Sonuç: Bu çal??mada kronik ürtiker tan?l? hasta gruplar?nda omalizumab tedavisinin etkinli?i ÜKT uygulanarak ara?t?r?ld?. Omalizumab tedavisini hem 12 aydan k?sa süreli, hem de 12 aydan uzun süreli alanlarda ÜKT sonuçlar?nda anlaml? bir iyile?me saptand?.

Anahtar Kelimeler: Kronik ürtiker, omalizumab, ürtiker kontrol testi