Omalizumab Re-Treatment and Step-Up in Patients with Chronic Spontaneous Urticaria: OPTIMA Trial.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
Historique:
received: 06 12 2019
revised: 05 03 2020
accepted: 13 03 2020
pubmed: 10 4 2020
medline: 15 5 2021
entrez: 10 4 2020
Statut: ppublish

Résumé

Omalizumab shows greater clinical benefit with 300 mg dose than with the 150 mg dose. To determine outcomes postwithdrawal, relapse, and re-treatment in omalizumab responders, and from stepping up to 300 mg after insufficient symptom control with 150 mg. This was a prospective, randomized (3:4), open-label, noncomparator study (clinicaltrials.gov: NCT02161562). A total of 314 adult patients with chronic spontaneous urticaria and symptomatic on H Overall, 115 of 314 patients had adequate symptom control at week 24 (end of the initial dosing period) and 56 were re-treated after relapse postwithdrawal; 87.8% (95% CI, 78.6%-96.9%) regained symptomatic control (UAS7 ≤ 6). Most (141 of 178) patients initially treated with 150 mg required step-up to 300 mg, which resulted in a 9.5-point (95% CI, 7.6-11.3) improvement in UAS7 over the mean change observed initially on 150 mg. Step-up to 300 mg helps a greater proportion of patients achieve symptom control, and re-treatment with omalizumab is as effective as initial therapy.

Sections du résumé

BACKGROUND
Omalizumab shows greater clinical benefit with 300 mg dose than with the 150 mg dose.
OBJECTIVE
To determine outcomes postwithdrawal, relapse, and re-treatment in omalizumab responders, and from stepping up to 300 mg after insufficient symptom control with 150 mg.
METHODS
This was a prospective, randomized (3:4), open-label, noncomparator study (clinicaltrials.gov: NCT02161562). A total of 314 adult patients with chronic spontaneous urticaria and symptomatic on H
RESULTS
Overall, 115 of 314 patients had adequate symptom control at week 24 (end of the initial dosing period) and 56 were re-treated after relapse postwithdrawal; 87.8% (95% CI, 78.6%-96.9%) regained symptomatic control (UAS7 ≤ 6). Most (141 of 178) patients initially treated with 150 mg required step-up to 300 mg, which resulted in a 9.5-point (95% CI, 7.6-11.3) improvement in UAS7 over the mean change observed initially on 150 mg.
CONCLUSIONS
Step-up to 300 mg helps a greater proportion of patients achieve symptom control, and re-treatment with omalizumab is as effective as initial therapy.

Identifiants

pubmed: 32272284
pii: S2213-2198(20)30282-8
doi: 10.1016/j.jaip.2020.03.022
pii:
doi:

Substances chimiques

Anti-Allergic Agents 0
Omalizumab 2P471X1Z11

Banques de données

ClinicalTrials.gov
['NCT02161562']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2372-2378.e5

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Gordon Sussman (G)

Department of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: gsussman@rogers.com.

Jacques Hébert (J)

Department of Medicine, Centre Hospitalier de l'Université Laval, Québec, QC, Canada.

Wayne Gulliver (W)

Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada.

Charles Lynde (C)

Lynde Institute for Dermatology, Markham, ON, Canada.

William H Yang (WH)

Ottawa Allergy Research Corporation, Department of Medicine, University of Ottawa Medical School, Ottawa, ON, Canada.

Kim Papp (K)

Clinical Research and Probity Medical Research, Waterloo, ON, Canada.

Melinda Gooderham (M)

SKiN Center for Dermatology, Queen's University and Probity Medical Research, Peterborough, ON, Canada.

Olivier Chambenoit (O)

Novartis Pharmaceuticals Corporation, East Hanover, NJ.

Sam Khalil (S)

Novartis Pharma AG, Basel, Switzerland.

Frederica DeTakacsy (F)

Novartis Pharmaceuticals Canada Inc, Dorval, QC, Canada.

Antonio Vieira (A)

Novartis Pharmaceuticals Canada Inc, Dorval, QC, Canada.

Lenka Rihakova (L)

Novartis Pharmaceuticals Canada Inc, Dorval, QC, Canada.

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