Urticaria Clinical Trial
Official title:
Effect of Anti-IgE in Chronic Urticaria
This study is being done to find out if a drug called Xolair (omalizumab), an anti-IgE antibody, is safe and effective for people with chronic urticaria (hives) with persistent symptoms in spite of taking antihistamines.
Omalizumab (Xolair®) is a recombinant humanized monoclonal antibody that binds specifically
to the FcEpsilonR1 binding site on human IgE. The binding of omalizumab inhibits the ability
of IgE to bind to basophils or mast cells. Free IgE levels fall by 89% and 98% over 16 and
24 weeks of therapy respectively (Busse, 2001). Total IgE levels rise in patients treated
with omalizumab though almost all IgE is bound and thus inactive. Omalizumab has also been
shown to decrease expression of the FcEpsilonR1 receptor on both basophils and mast cells
(Beck et al, 2004). Omalizumab recently received FDA approval for the treatment of moderate
to severe persistent allergic asthma in pediatric (12 years of age and above) and adult
patients. Studies have also shown efficacy in the treatment of allergic rhinitis and similar
anti-IgE compounds have been efficacious as food allergy therapeutics (Casale, 2001, and
Leung 2003).
Given the efficacy of omalizumab in the treatment of moderate to severe allergic asthma, the
researchers will conduct a double-blind study to evaluate the safety and efficacy of
omalizumab in a small number of patients with chronic urticaria with persistent symptoms in
spite of background antihistamine therapy. Omalizumab is currently not indicated for
patients with chronic urticaria. The primary hypothesis is that omalizumab will lead to a
reduction in serum IgE levels and blood basophil high affinity IgE receptor expression in
subjects with chronic idiopathic urticaria. Additionally, clinical outcomes such as quality
of life, symptoms scores, and medication use will be explored. This study should allow for
further understanding of the role IgE plays in chronic urticaria.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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