Omalizumab is a humanized, monoclonal anti-IgE antibody that interrupts the allergic cascade which suggests that it can be effective in the treatment of several allergic conditions, including atopic dermatitis (AD). We describe our Department’s experience in treating patients with severe AD and high levels of total IgE with omalizumab.
Twenty-four patients (14 male 10 female) 30,8 year-old average with severe AD,allergic respiratory disease and high levels of IgE (>2000 UI/L) not responding to conventional therapies were proposed for omalizumab treatment.They were evaluated for SCORAD index and daily/rescue medication before,during and after treatment.Omalizumab was administrated subcutaneously at doses range from 150 to 600 mg every 2 weeks for 19,6 months average treatment.
Before treatment all patients were medicated with anti-H1 and H2 antihistamine (maximum dose), montelukast 10 mg/day, topical and oral steroids (average dose 20mg/prednisolone/day) and topical primacrolimus. Seven patients were also medicated with cyclosporine and one of them was previously medicated with intravenous immunoglobulin G (1000mg/kg/month) with no response.
After treatment,all except one patient improved,although the onset for initial improvement was variable. The daily/rescue medication decreased in both dose and number of drugs. Systemic steroids were stopped with no relapse of symptoms. SCORAD index was 63,8 average at the beginning and 28,1 after treatment.
Only one patient experienced exuberant local reactions and stopped omalizumab.
Our data suggests that Omalizumab is a safe and effective alternative in the treatment of severe AD in allergic patients.