TY - JOUR
T1 - Use of omalizumab for management of idiopathic anaphylaxis
T2 - A systematic review and retrospective case series
AU - Kaminsky, Lauren W.
AU - Aukstuolis, Kestutis
AU - Petroni, Daniel H.
AU - Al-Shaikhly, Taha
N1 - Publisher Copyright:
© 2021 American College of Allergy, Asthma & Immunology
PY - 2021/10
Y1 - 2021/10
N2 - Background: Patients with idiopathic anaphylaxis (IA) may fail to respond to a combination of high-dose H1 and H2 antihistamines and mast cell stabilizers. Treatment options for these patients are currently limited. Objective: To describe the clinical experience of omalizumab use for the treatment of patients with IA with no evidence of underlying clonal mast cell disorders. Methods: We performed a retrospective review at 2 separate institutions of medical records of patients with a diagnosis of IA without evidence of mast cell clonality who had received treatment with omalizumab. We searched PubMed for studies describing omalizumab use in similar patients. Information on symptoms and omalizumab therapy was compiled, and response pattern of anaphylaxis was determined. Results: A total of 35 patients with IA and no evidence of mast cell clonality who received omalizumab were identified. The median age was 36 years at the start of omalizumab (range, 11-54 years; n = 29). The frequency of anaphylaxis episodes before omalizumab treatment varied from 2 total episodes to several episodes per month. The most often used initial omalizumab dose was 300 mg every 4 weeks (n = 16). Most patients ultimately achieved clinical response after starting omalizumab: complete response (63%, n = 22), partial response (28.5%, n = 10), with 3 nonresponders. Conclusion: Omalizumab may be an effective treatment option for patients with IA who do not have evidence of mast cell clonality and fail to respond to antihistamines and mast cell stabilizers.
AB - Background: Patients with idiopathic anaphylaxis (IA) may fail to respond to a combination of high-dose H1 and H2 antihistamines and mast cell stabilizers. Treatment options for these patients are currently limited. Objective: To describe the clinical experience of omalizumab use for the treatment of patients with IA with no evidence of underlying clonal mast cell disorders. Methods: We performed a retrospective review at 2 separate institutions of medical records of patients with a diagnosis of IA without evidence of mast cell clonality who had received treatment with omalizumab. We searched PubMed for studies describing omalizumab use in similar patients. Information on symptoms and omalizumab therapy was compiled, and response pattern of anaphylaxis was determined. Results: A total of 35 patients with IA and no evidence of mast cell clonality who received omalizumab were identified. The median age was 36 years at the start of omalizumab (range, 11-54 years; n = 29). The frequency of anaphylaxis episodes before omalizumab treatment varied from 2 total episodes to several episodes per month. The most often used initial omalizumab dose was 300 mg every 4 weeks (n = 16). Most patients ultimately achieved clinical response after starting omalizumab: complete response (63%, n = 22), partial response (28.5%, n = 10), with 3 nonresponders. Conclusion: Omalizumab may be an effective treatment option for patients with IA who do not have evidence of mast cell clonality and fail to respond to antihistamines and mast cell stabilizers.
UR - http://www.scopus.com/inward/record.url?scp=85111075821&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111075821&partnerID=8YFLogxK
U2 - 10.1016/j.anai.2021.06.017
DO - 10.1016/j.anai.2021.06.017
M3 - Article
C2 - 34175498
AN - SCOPUS:85111075821
SN - 1081-1206
VL - 127
SP - 481
EP - 487
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 4
ER -