Successful off-label use of omalizumab in a child with chronic spontaneous urticaria
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v33.i1.28163Keywords:
chronic spontaneous urticaria, omalizumab, Pediatrics, urticariaAbstract
Omalizumab is approved as third-line therapy for patients older than 12 years with antihistamine-refractory chronic spontaneous urticaria.
The authors present the case of an eight-year-old boy with a history of migratory maculopapular skin lesions, arthralgias, and conjunctival hyperemia. Laboratory findings were unremarkable. Skin biopsy was consistent with urticaria. Treatment with oral betamethasone and quadruple dose of bilastine was initiated, with clinical resolution of arthralgias and conjunctival hyperemia, but no improvement in skin lesions. After five months of illness, the patient developed several side effects of corticosteroids and was started on cyclosporine, with no clinical response after four weeks of treatment. At this point, he was started on off-label omalizumab 300 mg every four weeks, and corticosteroid therapy was discontinued after one month of treatment. After the third administration of omalizumab, the boy achieved complete clinical resolution.
Omalizumab may be an effective and safe treatment for antihistamine-refractory chronic spontaneous urticaria in pediatric age.
Downloads
References
Chang J, Cattelan L, Ben-Shoshan M, Le M, Netchiporouk E. Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines. J Asthma Allergy. 2021;14:187-99.
Fricke J, Ávila G, Keller T, Weller K, Lau S, Maurer M, et al. Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis. Allergy. 2020;75(2):423-32.
Caffarelli C, Paravati F, El Hachem M, Duse M, Bergamini M, Simeone G, et al. Management of chronic urticaria in children: a clinical guideline. Ital J Pediatr. 2019;45(1):101.
Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
Licari A, Marseglia A, Caimmi S, Castagnoli R, Foiadelli T, Barberi S, et al. Omalizumab in children. Paediatr Drugs. 2014;16(6):491-502.
Costa C, Gonçalo M. Abordagem diagnóstica e terapêutica da urticária crónica espontânea: recomendações em Portugal. Acta Med Port. 2016; 29:763-81.
Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr. 2015;58(5):159-64.
Rezzani R. Cyclosporine A and adverse effects on organs: histochemical studies. Prog Histochem Cytochem. 2004;39(2):85-128.
Corren J, Kavati A, Ortiz B, Colby JA, Ruiz K, Maiese BA, et al. Efficacy and safety of omalizumab in children and adolescents with moderate-to-severe asthma: A systematic literature review. Allergy Asthma Proc. 2017;38(4):250-63.
Al-Shaikhly T, Rosenthal JA, Ayars AG, Petroni DH. Omalizumab for chronic urticaria in children younger than 12 years. Ann Allergy Asthma Immunol. 2019;123(2):208-10.e2.
Passanisi S, Arasi S, Caminiti L, Crisafulli G, Salzano G, Pajno GB. Omalizumab in children and adolescents with chronic spontaneous urticaria: Case series and review of the literature. Dermatol Ther. 2020;33(4):e13489.
Corral-Magaña O, Gil-Sánchez JA, Bover-Bauzá C, Martinez-Cepas P, Montis-Palos MC, Martín-Santiago A. Chronic urticaria in children under 15 years of age: Clinical experience beyond the clinical trials. Pediatr Dermatol. 2021;38(2):385-9.
European Medicines Agency. Resumo das características do medicamento – Xolair [accessed 2022 Aug 2]. Available from: https://www.ema.europa.eu/en/documents/product-information/xolair-epar-product-information_pt.pdf.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Tânia Gonçalves, Iolanda Alen Coutinho, Joana Sofia Pita, Paula Leiria Pinto
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.
