Is Omalizumab Treatment Used During the COVID-19 Pandemic Effective on the Frequency and Severity of COVID-19?

Year 2023, Volume: 8 Issue: 3, 369 - 374, 06.09.2023

Rabia Öztaş Kara , Bahar Sevimli Dikicier , Ahmet Can Yağmur , Ahmet Kara , Mahizer Yaldız

https://doi.org/10.26453/otjhs.1282836

Abstract

Objective: The effects of drugs used in chronic spontaneous urticaria (CSU) and similar chronic dermatological diseases in COVID-19 continue to be the subject of many studies. The present study aimed to reveal the frequency and severity of COVID-19 infection in CSU patients treated with omalizumab and antihistamines.
Materials and Methods: CSU patients who were followed up and treated with omalizumab or antihistamines were evaluated retrospectively for clinical conditions with CSU and COVID-19 during the pandemic and compared with the control group regarding the incidence and severity of COVID-19 infection. In addition, urticaria disease severity was also compared with pre-pandemic scores for the CSU group.
Results: Real-time reverse transcription-polymerase chain reaction test positivity rate for SARS-CoV-2 was detected in 17.4%, 30.1%, and 34.8% of the patients in omalizumab, antihistamine, and control groups, respectively (p= 0.001). The disease activity scores were increased in both antihistamine and omalizumab treated compared to the pre-covid state CSU patients, while the increase was minor in patients using omalizumab.
Conclusion: The fact that COVID-19 infection was seen less frequent and urticaria activity scores were lower during the infection in the omalizumab group suggests that omalizumab treatment is safe and convenient to use during COVID-19 infection.

Keywords

Antihistamine, COVID-19, incidence, omalizumab, urticaria

COVID-19 Pandemisi Sırasında Kullanılan Omalizumab Tedavisi COVID-19 Sıklığı ve Şiddeti Üzerine Etkili midir?

Abstract

Amaç: Kronik spontan ürtiker (KSÜ) ve benzeri kronik dermatolojik hastalıklarda kullanılan ilaçların COVID-19'un seyri üzerindeki etkileri halen pek çok araştırma için çalışma konusu olmaya devam etmektedir. Sunulan çalışmada omalizumab ve antihistaminikler ile tedavi edilen KSÜ hastalarında COVID-19 enfeksiyonunun sıklığını ve şiddetini ortaya koymak hedeflenmiştir.
Materyal ve Metot: Omalizumab veya antihistaminiklerle izlenen ve tedavi edilen KSÜ hastalarının, pandemi sırasında KSÜ ve COVID-19 ile klinik durumları retrospektif olarak değerlendirildi ve COVID-19 enfeksiyonunun insidansı ve şiddeti açısından kontrol grubu ile karşılaştırıldı. Ayrıca ürtiker hastalığının şiddeti, KSÜ grubu için pandemi öncesi skorlarla karşılaştırıldı.
Bulgular: SARS-CoV-2 için gerçek zamanlı ters transkripsiyon-polimeraz zincir reaksiyonu testi pozitiflik oranı omalizumab, antihistaminik ve kontrol gruplarındaki hastaların sırasıyla %17,4, %30,1 ve %34,8'inde tespit edildi (p= 0,001). Hastalık aktivitesi skorları covid öncesi duruma kıyasla hem antihistaminik hem de omalizumab ile tedavi edilen KSÜ hastalarında artarken, omalizumab kullanan hastalarda artış daha düşük oranda saptanmıştır.
Sonuç: Omalizumab grubunda COVID-19 enfeksiyonunun daha az görülmesi ve enfeksiyon sırasında ürtiker aktivite skorlarının daha düşük olması, omalizumab tedavisinin COVID-19 enfeksiyonu sırasında kullanımının güvenli ve uygun olduğunu göstermektedir.

Keywords

Antihistamin, COVID-19, insidans, omalizumab, ürtiker

References

• Coronavirus Resource Center of the John Hopkins University [Internet]. The COVID-19 testing insights initiative; 2021. https://coronavirus.jhu.edu/. Accessed June 23, 2021.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5
• Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-887. doi:10.1111/all.12313
• Grieco T, Dies L, Sernicola A, et al. Potential clinical and serological predictors of chronic spontaneous urticaria relapse in patients under omalizumab treatment. Immunotherapy. 2020;12(16):1173-1181. doi:10.2217/imt-2020-0088
• Saini SS, Bindslev-Jensen C, Maurer M, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo-controlled study. J Invest Dermatol. 2015;135(1):67-75. doi:10.1038/jid.2014.306
• Acer E, Kaya Erdogan H, Yüksel Çanakçı N, Saracoglu ZN. The effect of omalizumab on hematological and inflammatory parameters in patients with chronic spontaneous urticaria. Cutan Ocul Toxicol. 2019;38(1):5-8. doi:10.1080/15569527.2018.1495227
• Lommatzsch M, Stoll P, Virchow JC. COVID-19 in a patient with severe asthma treated with Omalizumab. Allergy. 2020;75(10):2705-2708. doi:10.1111/all.14456
• Vultaggio A, Agache I, Akdis CA, et al. Considerations on biologicals for patients with allergic disease in times of the COVID-19 pandemic: An EAACI statement. Allergy. 2020;75(11):2764-2774. doi:10.1111/all.14407
• Salman A, Alper S, Atakan N, et al. Recommendations on the use of systemic treatments for urticaria and atopic dermatitis during the COVID-19 pandemic: Statement of Dermatoallergy Working Group of the Turkish Society of Dermatology. Turkderm-Turk Arch Dermatol Venereology. 2020;54:71-75. doi:10.4274/turkderm.galenos.2020.80000
• Hogan Ii RB, Hogan Iii RB, Cannon T, et al. Dual-histamine receptor blockade with cetirizine-famotidine reduces pulmonary symptoms in COVID-19 patients. Pulm Pharmacol Ther. 2020;63:101942. doi:10.1016/j.pupt.2020.101942
• Wang T, Hou W, Fu Z. Preventative effect of OMZ-SPT on lipopolysaccharide-induced acute lung injury and inflammation via nuclear factor-kappa B signaling in mice. Biochem Biophys Res Commun. 2017;485(2):284-289. doi:10.1016/j.bbrc.2017.02.090
• Living guidance for clinical management of COVID-19; 2021. https://www.who.int/publications/i/item/WHO 2019-nCoV-clinical-2021-2. Accessed Nov 23, 2021.
• Criado PR, Criado RFJ, Pincelli TP, Yoshimoto TA, Naufal GGA, Abdalla BMZ. Chronic spontaneous urticaria exacerbation in a patient with COVID-19: rapid and excellent response to omalizumab. Int J Dermatol. 2020;59(10):1294-1295. doi:10.1111/ijd.15134
• Alizadeh Aghdam M, Knol EF, van den Elzen M, et al. Response of FcεRI-bearing leucocytes to omalizumab in chronic spontaneous urticaria. Clin Exp Allergy. 2020;50(3):364-371. doi:10.1111/cea.13566
• Kritas SK, Ronconi G, Caraffa A, Gallenga CE, Ross R, Conti P. Mast cells contribute to coronavirus-induced inflammation: new anti-inflammatory strategy. J Biol Regul Homeost Agents. 2020;34(1):9-14. doi:10.23812/20-Editorial-Kritas
• Kocatürk E, Salman A, Cherrez-Ojeda I, et al. The global impact of the COVID-19 pandemic on the management and course of chronic urticaria. Allergy. 2021;76(3):816-830. doi:10.1111/all.14687
• Branco ACCC, Yoshikawa FSY, Pietrobon AJ, Sato MN. Role of Histamine in Modulating the Immune Response and Inflammation. Mediators Inflamm. 2018;9524075. doi:10.1155/2018/9524075
• Gill MA, Liu AH, Calatroni A, et al. Enhanced plasmacytoid dendritic cell antiviral responses after omalizumab. J Allergy Clin Immunol. 2018;141(5):1735-1743.e9. doi:10.1016/j.jaci.2017.07.035
• Lee JS, Shin EC. The type I interferon response in COVID-19: implications for treatment. Nat Rev Immunol. 2020;20(10):585-586. doi:10.1038/s41577-020-00429-3
• Bostan E, Zaid F, Karaduman A, et al. The effect of COVID-19 on patients with chronic spontaneous urticaria treated with omalizumab and antihistamines: A cross-sectional, comparative study. J Cosmet Dermatol. 2021;20(11):3369-3375. doi:10.1111/jocd.14484