奥马珠单抗对慢性荨麻疹合并过敏性休克患者的应用研究

Clinical application of omalizumab in patients with chronic urticaria complicated with anaphylactic shock

目的:探讨奥马珠单抗(omalizumab)在对抗组胺药物治疗不佳、有过敏性休克病史的慢性荨麻疹患者中的应用疗效和安全性评估。方法:采用回顾性观察性的真实世界研究,选取2018年11月至2024年1月北京大学第一医院收治的对抗组胺药物治疗不佳且有过敏性休克史的慢性荨麻疹患者作为研究对象,每4周给予300 mg奥马珠单抗皮下注射,并在治疗期间记录荨麻疹控制评分(urticaria control test,UCT)、过敏性休克的发生次数和其他不良事件。结果:11例患者在开始使用奥马珠单抗治疗3个月后,其中10例患者的慢性荨麻疹情况得到完全控制(UCT=16),1例患者为部分控制(UCT=15);9例患者随访期间未出现过敏性休克(随访12个月以上10例,随访2个月1例)。2例患者在注射奥马珠单抗后发生过敏性休克。本研究中,在随访期间(2~38个月)11例患者均对奥马珠单抗的耐受性良好,其中4例继续使用奥马珠单抗治疗荨麻疹,6例由于荨麻疹控制良好和没有再次发生过敏性休克停止使用奥马珠单抗,1例失访。结论:奥马珠单抗对抗组胺药物治疗不佳且有过敏性休克病史的慢性荨麻疹患者可能具有良好的疗效和安全性,且可能具有潜在的预防过敏性休克的作用。

ObjectiveTo investigate the efficacy and safety evaluation of omalizumab in patients with chronic urticaria who are not well treated with antihistamine and have a history of anaphylactic shock.MethodsA retrospective observational real-world study was conducted in which patients with chronic urticaria who were admitted to Peking University First Hospital from November 2018 to January 2024 who were poorly treated with antihistamine drugs and had a history of anaphylactic shock were selected as the study subjects,and 300 mg of omalizumab was injected subcutaneously every 4 weeks,and the occurrence of UCT(urticaria control test),the number of occurrences of anaphylactic shock and other adverse events were recorded during the treatment.ResultsAmong the 11 patients who started omalizumab treatment for 3 months,10 patients had complete control of chronic urticaria(UCT=16),1 patient was partially controlled(UCT=15),and 9 patients did not have anaphylactic shock during follow-up(10 cases after 12 months of follow-up and 1 case after 2 months of follow-up).Two patients developed anaphylactic shock after omalizumab injection.In this study,during the follow-up period(2-38 months),11 patients were well tolerated with omalizumab,of which 4 continued to use omalizumab for urticaria,6 stopped using omalizumab due to good urticaria control and no recurrence of anaphylactic shock,and 1 was lost to follow-up.ConclusionOmalizumab may have good efficacy and safety in patients with chronic urticaria who are poorly treated with antihistamines and have a history of anaphylactic shock,and may have a potential role in preventing anaphylactic shock.