Journal ArticleDOI
Omalizumab in patients with chronic spontaneous urticaria: a systematic review and GRADE assessment
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TLDR
There was high‐quality evidence to support the effectiveness and safety of omalizumab 300 mg per month for the treatment of CSU for up to 6 months.Abstract:
Summary Chronic spontaneous urticaria (CSU) is characterized by the occurrence of hives, angio-oedema or both for a period of at least 6 weeks. Many patients remain symptomatic despite treatment with H 1 antihistamines, even at higher doses. This systematic review assessed the quality of the evidence for the effects of omalizumab as treatment in patients with CSU. We searched PubMed, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials up to 7 August 2014. Three review authors independently carried out study selection, risk of bias assessment and data extraction. Two review authors analysed the data. Five randomized controlled trials (RCTs), which included 1116 participants, were evaluated. All the RCTs were judged as having a low risk of bias. There was a statistically significant improvement in measures of disease activity and quality of life following treatment with omalizumab when compared with placebo [mean difference (MD) -11·58, 95% confidence interval (CI) -13·39 to -9·77 and MD -13·12, 95% CI -16·30 to -9·95, respectively]. Complete response and partial response were more frequent after treatment with omalizumab [risk ratio (RR) 6·44, 95% CI 3·95-10·49 and RR 4·08, 95% CI 2·98-5·60, respectively]. There was no difference in the proportion of participants reporting adverse events between the omalizumab and placebo treatment groups (RR 1·05, 95% CI 0·96-1·16). There was high-quality evidence to support the effectiveness and safety of omalizumab 300 mg per month for the treatment of CSU for up to 6 months. What's already known about this topic? Despite available treatment options many patients with chronic spontaneous urticaria remain symptomatic The recently published EAACI/GA 2 LEN/EDF/WAO guideline recommends omalizumab as 'add-on' therapy to second-generation H 1 antihistamines as third line treatment What does this study add? A detailed GRADE assessment indicated high-quality evidence for the effectiveness and safety of omalizumab 300 mg per month for up to 6 monthsread more
Citations
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Iconographies supplémentaires de l'article : Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy
Allen P. Kaplan,Dennis K. Ledford,Mark Ashby,Janice Canvin,James L. Zazzali,Edward Conner,Joachim Veith,Nikhil Kamath,Petra Staubach,Thilo Jakob,Robert G Stirling,Piotr Kuna,William E. Berger,Marcus Maurer,Karin Rosén +14 more
TL;DR: In this paper, the authors evaluated the safety and efficacy of 24 weeks of treatment with omalizumab in patients with persistent chronic idiopathic urticaria/chronic spontaneous urticria (CIU/CSU) despite treatment with H1-antihistamines, leukotriene receptor antagonists, or both.
Journal ArticleDOI
Omalizumab for the treatment of chronic spontaneous urticaria: A meta-analysis of randomized clinical trials
Zuo-Tao Zhao,Chun-Mei Ji,Wen-Jun Yu,Ling Meng,Tomasz Hawro,Ji-Fu Wei,Marcus Maurer,Marcus Maurer +7 more
TL;DR: A meta-analysis of clinical trial results provided high-quality evidence for the efficacy and safety of omalizumab in patients with CSU and for treating these patients with 300 mg of o malizumAB every 4 weeks.
Journal ArticleDOI
Immunoglobulin E-Mediated Autoimmunity.
TL;DR: A comprehensive review of the literature on IgE-mediated autoallergy focuses on three related questions: What do the authors know about the prevalence of IgE autoantibodies and their targets in different diseases?
Journal ArticleDOI
New treatments for chronic urticaria
TL;DR: Omalizumab, the treatment of choice in patients with antihistamine-resistant chronic spontaneous urticaria (CSU), should be explored for the use in chronic inducible uricaria, in children <12 years old with CSU, and at higher doses.
Journal ArticleDOI
Similar Efficacy with Omalizumab in Chronic Idiopathic/Spontaneous Urticaria Despite Different Background Therapy
Thomas B. Casale,Jonathan A. Bernstein,Marcus Maurer,Sarbjit S. Saini,Benjamin Trzaskoma,Hubert Chen,Clive Grattan,Ana Giménez-Arnau,Allen P. Kaplan,Karin Rosén +9 more
TL;DR: Omalizumab 300 mg was safe and effective in reducing CIU/CSU symptoms regardless of background therapy and the overall safety profile was generally consistent with omalizUMab therapy in allergic asthma.
References
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Journal ArticleDOI
Grading quality of evidence and strength of recommendations.
David C. Atkins,Dana Best,Peter A. Briss,Martin P Eccles,Yngve Falck-Ytter,Signe Flottorp,Gordon H. Guyatt,Robin Harbour,Margaret C Haugh,David Henry,Suzanne Hill,Roman Jaeschke,Gillian Leng,Alessandro Liberati,Nicola Magrini,James Mason,Philippa Middleton,Jacek Mrukowicz,Dianne L. O'Connell,Andrew D Oxman,Bob Phillips,Holger J. Schünemann,Tessa Tan-Torres Edejer,H. Varonen,Gunn Elisabeth Vist,John W Williams,Stephanie Zaza +26 more
TL;DR: A system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts is developed, and a summary of the approach from the perspective of a guideline user is presented.
Journal ArticleDOI
The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update.
Torsten Zuberbier,Werner Aberer,Riccardo Asero,Carsten Bindslev-Jensen,Zenon Brzoza,Giorgio Walter Canonica,Martin K. Church,Luis Felipe Ensina,Ana Giménez-Arnau,Kiran Godse,Margarida Gonçalo,Clive Grattan,Jacques Hébert,Michihiro Hide,Allen P. Kaplan,Alexander Kapp,A H Abdul Latiff,P. Mathelier-Fusade,Martin Metz,Alexander Nast,Sarbjit S. Saini,Mario Sánchez-Borges,Peter Schmid-Grendelmeier,F. E. R. Simons,Petra Staubach,Gordon Sussman,Elias Toubi,Gino A. Vena,Bettina Wedi,X J Zhu,Markus Maurer +30 more
TL;DR: This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms, and outlines evidence-based diagnostic and therapeutic approaches for the different subtypes ofUrticaria.
Journal ArticleDOI
Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria
Marcus Maurer,Karin Rosén,Hsin-Ju Hsieh,Sarbjit S. Saini,Clive Grattan,Ana Giménez-Arnau,Sunil Agarwal,Ramona Doyle,Janice Canvin,Allen P. Kaplan,Thomas B. Casale +10 more
TL;DR: Omalizumab diminished clinical symptoms and signs of chronic idiopathic urticaria in patients who had remained symptomatic despite the use of approved doses of H-antihistamine therapy (licensed doses).
Journal ArticleDOI
Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report.
Marcus Maurer,Karsten Weller,Carsten Bindslev-Jensen,Ana Giménez-Arnau,P. J. Bousquet,Jean Bousquet,G.W. Canonica,M. K. Church,M. K. Church,Kiran Godse,Clive Grattan,Malcolm W. Greaves,Michihiro Hide,Dimitris Kalogeromitros,Allen P. Kaplan,Sarbjit S. Saini,X J Zhu,T. Zuberbier +17 more
TL;DR: A GA2LEN task force report concluded that chronic spontaneous urticaria is a “hidden epidemic” that needs to be addressed to address the unmet clinical needs of patients.
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