viernes, 22 de marzo de 2013

Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria — NEJM

Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria — NEJM


Original Article


Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria



Marcus Maurer, M.D., Karin Rosén, M.D., Ph.D., Hsin-Ju Hsieh, Ph.D., Sarbjit Saini, M.D., Clive Grattan, M.D., Ana Gimenéz-Arnau, M.D., Ph.D., Sunil Agarwal, M.D., Ramona Doyle, M.D., Janice Canvin, M.D., Allen Kaplan, M.D., and Thomas Casale, M.D.


N Engl J Med 2013; 368:924-935March 7, 2013DOI: 10.1056/NEJMoa1215372



Abstract

Article

References

Citing Articles (1)






Background


Many patients with chronic idiopathic urticaria (also called chronic spontaneous urticaria) do not have a response to therapy with H1-antihistamines, even at high doses. In phase 2 trials, omalizumab, an IgE monoclonal antibody that targets IgE and affects mast-cell and basophil function, has shown efficacy in such patients.






Methods


In this phase 3, multicenter, randomized, double-blind study, we evaluated the efficacy and safety of omalizumab in patients with moderate-to-severe chronic idiopathic urticaria who remained symptomatic despite H1-antihistamine therapy (licensed doses). We randomly assigned 323 patients to receive three subcutaneous injections, spaced 4 weeks apart, of omalizumab at doses of 75 mg, 150 mg, or 300 mg or placebo, followed by a 16-week observation period. The primary efficacy outcome was the change from baseline in a weekly itch-severity score (ranging from 0 to 21, with higher scores indicating more severe itching).






Results


The baseline weekly itch-severity score was approximately 14 in all four study groups. At week 12, the mean (±SD) change from baseline in the weekly itch-severity score was −5.1±5.6 in the placebo group, −5.9±6.5 in the 75-mg group (P=0.46), −8.1±6.4 in the 150-mg group (P=0.001), and −9.8±6.0 in the 300-mg group (P<0 .001="" 12="" 150-mg="" 300-mg="" 75-mg="" across="" adverse="" although="" at="" dose-dependent="" each="" effects.="" either="" events="" for="" frequency="" group="" groups.="" higher="" in="" low="" most="" of="" or="" outcomes="" p="" placebo="" prespecified="" rate="" secondary="" serious="" showed="" similar="" than="" the="" was="" week="">





Conclusions


Omalizumab diminished clinical symptoms and signs of chronic idiopathic urticaria in patients who had remained symptomatic despite the use of approved doses of H1-antihistamines. (Funded by Genentech and Novartis Pharma; ClinicalTrials.gov number, NCT01292473.)







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