Treatment of recalcitrant atopic dermatitis with omalizumab

Department of Internal Medicine, Mercer University, Атланта, Michigan, United States
Journal of the American Academy of Dermatology (Impact Factor: 5). 02/2006; 54(1):68-72. DOI: 10.1016/j.jaad.2005.09.030
Source: PubMed

ABSTRACT Atopic dermatitis is a common diagnosis that presents a therapeutic challenge. Although multiple therapeutic modalities exist, there is no single monotherapy that has proven exceptional in ameliorating the symptoms of this disease. Current topical and systemic therapeutic options offer benefit but carry varying degrees of adverse effects that often limit their application. We present 3 patients with severe, recalcitrant atopic dermatitis successfully treated with omalizumab.

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    • "It binds free IgE but not IgE bound to FcεRI on masts cells, so in this way it sequesters free IgE without activating bound IgE and causing mast cell degranulation (Presta et al., 1993). Omalizumab has been approved by the FDA for use in severe recalcitrant asthma (Strunk & Bloomberg, 2006) and has been investigated for severe cases of atopic dermatitis with positive results (Lane et al., 2006). "
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    • "In the two positive studies, doses corresponding to recommended, according to individual weight and IgE level, were used except for a 13-year-old child with a serum IgE level of 6120 IU/mL who was treated with a 450 mg dose. The level of total IgE appeared a critical factor, considering that the three patients in the unsuccessful study had a mean starting level of 17.600 IU/mlL(Krathen et al 2006) compared with a mean level of 3600 IU/mL in the pediatric study (Lane et al 2006), and of 1060 IU/mL in the study on adults and children (Vigo et al 2006). However, the available data on omalizumab in AD cannot indicate the optimal level of IgE for predicting a positive response to treatment and, as noted by the authors of the studies, well-designed controlled trials are needed to explore such issue, comparing patients with different IgE levels. "
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