Biological therapy for chronic urticaria

Biological therapy for chronic urticaria

N.N. Zhukova, K.S. Mazokha, M.V. Manzhos, A.V. Aseeva

Reaviz Medical University, Samara 

Chronic urticaria is a quite common disease among adults, often lasting for a long time, more than a year, and in some patients, more than 5 years. The key mechanism for the appearance of blisters and angioedema is mast cell degranulation with proinflammatory mediator release (histamine, serotonin, interleukins, tumor necrosis factor α, platelet activating factor, etc.). Degranulation can also be caused by complement components, certain medications, physical factors, and unknown mechanisms. At the first stage of treatment of chronic spontaneous urticaria, antihistamines are used in standard and multiply increased dosages. At the second stage, in the lack of clinical improvement, a genetically engineered biological drug is recommended. This paper describes a patient with severe chronic spontaneous urticaria. Maximum doses of antihistamines taken for a long time did not provide disease control, whereas systemic steroids could not be prescribed because of poor tolerance. Administration of omalizumab provided rapid relief of skin lesions without additional prescription of antihistamines and total control over the disease course.

Keywords: chronic urticaria, prednisolone, severe course, omalizumab, biological therapy.