Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointes...Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointestinal symptoms,or even anaphylactic shock.Research on acute spontaneous urticaria is limited,with unclear etiology,and treatment largely relies on antihistamines and corticosteroids,which may not prevent progression to chronic urticaria.In this study,three patients with acute spontaneous urticaria,unresponsive to conventional treatments,chose a single 300mg subcutaneous injection of Omalizumab after evaluating the risks and benefits.Within 1-3 days,all patients showed significant symptom improvement,with near-complete resolution of lesions.Within a week,they resumed normal daily activities,and no recurrence was observed during 12 months of follow-up,with no adverse reactions.This study demonstrates the efficacy and safety of Omalizumab for acute spontaneous urticaria,particularly in cases resistant to antihistamines and corticosteroids.Early administration of Omalizumab can effectively control disease progression,reduce impact on daily life,and may lower the risk of developing chronic urticaria.These findings suggest that Omalizumab should be considered a valuable option in treating acute spontaneous urticaria,especially when conventional therapies fail,offering rapid symptom relief and long-term disease control.展开更多
In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with l...In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with long actingβ-agonists(LABA)(GINA step 3 or higher),and urticaria.We report a case of joint and Achilles tendon inflammatory reactions in a patient with Th2-type asthma receiving omalizumab treatment.An adult male presented with recurrent episodes of sneezing,rhinorrhea,wheezing,chest tightness,shortness of breath,and dyspnea.He exhibited allergies to multiple substances and demonstrated impaired lung function,ultimately being diagnosed with allergic rhinitis and asthma.Following initial treatment with ICS and LABA,his symptoms were initially controlled.However,as the disease progressed,the frequency of nocturnal attacks increased,and the incidence of attacks during the allergy season escalated,leading to a significant decline in lung function.Subsequently,he commenced subcutaneous injections of omalizumab at a dosage of 600 mg monthly.There was a partial improvement in the frequency of asthma attacks after two injections.Unfortunately,four days after the first treatment,he reported pain in the right Achilles tendon.Rheumatological screenings,including a five-item antinuclear antibody test and an 11-item autoantibody profile test,revealed no significant abnormalities.Ankle joint ultrasound indicated hyperechoic spots around the Achilles tendon with acoustic shadows,suggesting the presence of Achilles tendinopathy.Ten days later,the pain symptoms resolved spontaneously.Due to the sig-nificant improvement in asthma symptoms,omalizumab treatment continued,albeit with a dosage reduction to 300mg.After intermittent treatment over four sessions,asthma symptoms improved markedly,with the Asthma Control Test(ACT)score increasing from 14 to 20.Lung function improved from moderate obstruction to mild obstruction.The only drawback was the patient’s recurrent swelling,pain,and joint effusion in the joints(specifically the knee and ankle)during the treatment period.Omalizumab is an effective therapeutic option for the treatment of allergic asthma.Although the incidence of adverse events reported in current studies is low,there have been emerging reports of joint swelling,pain,and myalgia reactions in both children and adults receiving treatment for asthma and urticaria.Given the rarity and non-specific nature of these reactions,it is challenging to ascertain the true incidence rate.Previous reports have described symptoms that occur upon initiation of the medication,which can recur upon re-administration.While the factors that may increase the risk of joint inflammatory reactions to omalizumab remain to be elucidated,this case contributes to a deeper understanding of this adverse reaction associated with a well-tolerated and important therapeutic agent.展开更多
Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including sys...Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.展开更多
A 14-year-old girl with poorly controlled asthma attended the difficult-to-treat asthma clinic for review.Although she has eosinophilia and significantly raised immunoglobulin E levels,she is not currently a candidate...A 14-year-old girl with poorly controlled asthma attended the difficult-to-treat asthma clinic for review.Although she has eosinophilia and significantly raised immunoglobulin E levels,she is not currently a candidate for omalizumab(Xolair).She also suffers from chronic urticaria,eosinophilic eosophagitis and severe conjunctivitis.You wonder if omalizumab would be effective in treating her multiple atopic conditions,in particular her troublesome conjunctivitis.PubMed was searched using the following search terms:(Omalizumab)or(Xolair)and(conjunctivitis).Searches were conducted in November 2020.Abstracts were selected for full text review if the study population identified asthma as a comorbidity.Non-paediatric studies and those that were not written in English were excluded.The use of omalizumab has the potential to be effective in the treatment of conjunctivitis associated with asthma and other atopic conditions.However,research is needed to address the question,in the form of multicenter,double-blind randomized control trials.展开更多
To the Editor:The global prevalence of chronic spontaneous urticaria(CSU)is estimated to be approximately 0.5–1%,with approximately 0.75%in China.[1,2]Secondgeneration H1-antihistamines(H1AHs)at a standard dose are c...To the Editor:The global prevalence of chronic spontaneous urticaria(CSU)is estimated to be approximately 0.5–1%,with approximately 0.75%in China.[1,2]Secondgeneration H1-antihistamines(H1AHs)at a standard dose are currently the preferred first-line treatment for CSU.In the case of an inadequate response to H1AHs after 1–2 weeks of treatment,the dose of the same H1AH could be increased to a maximum of 4-fold,or it could be combined with other antihistamines.For patients with CSU who remain intolerant or unresponsive despite 2–4 weeks of treatment with increased doses of antihistamines,omalizumab,a humanized recombinant anti-immunoglobulin E(IgE)monoclonal antibody(300 mg every 4 weeks),is recommended as third-line treatment.[3]展开更多
文摘Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointestinal symptoms,or even anaphylactic shock.Research on acute spontaneous urticaria is limited,with unclear etiology,and treatment largely relies on antihistamines and corticosteroids,which may not prevent progression to chronic urticaria.In this study,three patients with acute spontaneous urticaria,unresponsive to conventional treatments,chose a single 300mg subcutaneous injection of Omalizumab after evaluating the risks and benefits.Within 1-3 days,all patients showed significant symptom improvement,with near-complete resolution of lesions.Within a week,they resumed normal daily activities,and no recurrence was observed during 12 months of follow-up,with no adverse reactions.This study demonstrates the efficacy and safety of Omalizumab for acute spontaneous urticaria,particularly in cases resistant to antihistamines and corticosteroids.Early administration of Omalizumab can effectively control disease progression,reduce impact on daily life,and may lower the risk of developing chronic urticaria.These findings suggest that Omalizumab should be considered a valuable option in treating acute spontaneous urticaria,especially when conventional therapies fail,offering rapid symptom relief and long-term disease control.
文摘In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with long actingβ-agonists(LABA)(GINA step 3 or higher),and urticaria.We report a case of joint and Achilles tendon inflammatory reactions in a patient with Th2-type asthma receiving omalizumab treatment.An adult male presented with recurrent episodes of sneezing,rhinorrhea,wheezing,chest tightness,shortness of breath,and dyspnea.He exhibited allergies to multiple substances and demonstrated impaired lung function,ultimately being diagnosed with allergic rhinitis and asthma.Following initial treatment with ICS and LABA,his symptoms were initially controlled.However,as the disease progressed,the frequency of nocturnal attacks increased,and the incidence of attacks during the allergy season escalated,leading to a significant decline in lung function.Subsequently,he commenced subcutaneous injections of omalizumab at a dosage of 600 mg monthly.There was a partial improvement in the frequency of asthma attacks after two injections.Unfortunately,four days after the first treatment,he reported pain in the right Achilles tendon.Rheumatological screenings,including a five-item antinuclear antibody test and an 11-item autoantibody profile test,revealed no significant abnormalities.Ankle joint ultrasound indicated hyperechoic spots around the Achilles tendon with acoustic shadows,suggesting the presence of Achilles tendinopathy.Ten days later,the pain symptoms resolved spontaneously.Due to the sig-nificant improvement in asthma symptoms,omalizumab treatment continued,albeit with a dosage reduction to 300mg.After intermittent treatment over four sessions,asthma symptoms improved markedly,with the Asthma Control Test(ACT)score increasing from 14 to 20.Lung function improved from moderate obstruction to mild obstruction.The only drawback was the patient’s recurrent swelling,pain,and joint effusion in the joints(specifically the knee and ankle)during the treatment period.Omalizumab is an effective therapeutic option for the treatment of allergic asthma.Although the incidence of adverse events reported in current studies is low,there have been emerging reports of joint swelling,pain,and myalgia reactions in both children and adults receiving treatment for asthma and urticaria.Given the rarity and non-specific nature of these reactions,it is challenging to ascertain the true incidence rate.Previous reports have described symptoms that occur upon initiation of the medication,which can recur upon re-administration.While the factors that may increase the risk of joint inflammatory reactions to omalizumab remain to be elucidated,this case contributes to a deeper understanding of this adverse reaction associated with a well-tolerated and important therapeutic agent.
文摘Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. Latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.
文摘A 14-year-old girl with poorly controlled asthma attended the difficult-to-treat asthma clinic for review.Although she has eosinophilia and significantly raised immunoglobulin E levels,she is not currently a candidate for omalizumab(Xolair).She also suffers from chronic urticaria,eosinophilic eosophagitis and severe conjunctivitis.You wonder if omalizumab would be effective in treating her multiple atopic conditions,in particular her troublesome conjunctivitis.PubMed was searched using the following search terms:(Omalizumab)or(Xolair)and(conjunctivitis).Searches were conducted in November 2020.Abstracts were selected for full text review if the study population identified asthma as a comorbidity.Non-paediatric studies and those that were not written in English were excluded.The use of omalizumab has the potential to be effective in the treatment of conjunctivitis associated with asthma and other atopic conditions.However,research is needed to address the question,in the form of multicenter,double-blind randomized control trials.
文摘To the Editor:The global prevalence of chronic spontaneous urticaria(CSU)is estimated to be approximately 0.5–1%,with approximately 0.75%in China.[1,2]Secondgeneration H1-antihistamines(H1AHs)at a standard dose are currently the preferred first-line treatment for CSU.In the case of an inadequate response to H1AHs after 1–2 weeks of treatment,the dose of the same H1AH could be increased to a maximum of 4-fold,or it could be combined with other antihistamines.For patients with CSU who remain intolerant or unresponsive despite 2–4 weeks of treatment with increased doses of antihistamines,omalizumab,a humanized recombinant anti-immunoglobulin E(IgE)monoclonal antibody(300 mg every 4 weeks),is recommended as third-line treatment.[3]
