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Ling X, Shou X, Lou Y, Ling J, Zhang M, Yu T, Gu W. Research progress of omalizumab in the treatment of bullous pemphigoid. J Dermatol 2023; 50:575-587. [PMID: 36971190 DOI: 10.1111/1346-8138.16791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
Bullous pemphigoid (BP) is an autoimmune blistering disease associated with anti-BP180 and anti-BP230 antibodies. The pathogenic action mechanism of immunoglobulin E (IgE) antibodies in BP has been studied since the 1970s, and IgE antibodies have gradually been confirmed as being important in BP; therefore, anti-IgE therapy may be a new option for the treatment of BP. Omalizumab, as an IgE monoclonal antibody, has been increasingly used clinically to treat BP in recent years. Here, we collected 35 papers investigating omalizumab for BP treatment in a total of 83 patients, and the vast majority of patients showed varying degrees of improvement after treatment, except for a small number of patients with poor clinical outcomes. The patients were then divided into three groups according to dosing frequency and number of doses. Statistical analysis indicated that dosing frequency had little effect on clinical efficacy. While the groups with different numbers of doses were evaluated, the results concluded that clinical efficacy was affected by the number of doses, but there was no positive correlation between the number of doses and clinical efficacy.
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Affiliation(s)
- Xiaoya Ling
- The First Clinical Medical College of Zhejiang Chinese Medicine University, 310053, Hangzhou, China
| | - Xinyang Shou
- The First Clinical Medical College of Zhejiang Chinese Medicine University, 310053, Hangzhou, China
| | - Yufei Lou
- The First Clinical Medical College of Zhejiang Chinese Medicine University, 310053, Hangzhou, China
| | - Jie Ling
- The First Clinical Medical College of Zhejiang Chinese Medicine University, 310053, Hangzhou, China
| | - Mengyuan Zhang
- The First Clinical Medical College of Zhejiang Chinese Medicine University, 310053, Hangzhou, China
| | - Tugen Yu
- The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine (Zhejiang Province Hospital of Chinese Medicine), Hangzhou, 310006, China
| | - Weijia Gu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
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D'Aguanno K, Gabrielli S, Ouchene L, Muntyanu A, Ben-Shoshan M, Zhang X, Iannattone L, Netchiporouk E. Omalizumab for the Treatment of Bullous Pemphigoid: A Systematic Review of Efficacy and Safety. J Cutan Med Surg 2022; 26:404-413. [PMID: 35379011 DOI: 10.1177/12034754221089267] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bullous pemphigoid (BP) is an autoimmune blistering skin disease. Current treatment strategies are limited by their efficacy and/or side effect profile and the need for safer and effective alternatives is undeniable. We aimed to conduct a systematic review focusing on the efficacy and safety of omalizumab in BP patients. Embase, PubMed, Cochrane, and clinicaltrials.gov were searched for English and French articles published from inception to July 1, 2021, using search terms "omalizumab" OR "Xolair" OR "IGE025" OR "olizumab" AND "bullous pemphigoid." Screening and data extraction was performed by two raters independently. The primary outcome was complete response (CR), and secondary outcomes were partial response (PR), flare-ups, adverse events/vital status. In total, 22 articles were included, with a total of 56 patients. All patients had a refractory BP with mean disease duration of 13.5 ± 20.2 months (Standard Deviation (SD)) and failed 3.1 ± 1.6 therapies and many remained corticosteroids dependent. Overall, 87.5% of patients responded to treatment (55.4% CR and 32.1% PR), 7.1% discontinued the protocol and only 5.4% were non responders. A third of patients were able to discontinue all other therapies and most others were able to discontinue or taper systemic corticosteroids to <10 mg daily. Flare-ups occurred in 57.7% of patients upon discontinuation of omalizumab and/or steroid tapering, most patients recaptured response thereafter. Omalizumab was well tolerated by most patients. Omalizumab appears to be a promising treatment for BP with a good response rate and safety profile. However, several limitations were identified in current literature, and highlight the need for randomized controlled trials of omalizumab in BP.
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Affiliation(s)
| | | | - Lydia Ouchene
- 54473 Division of Dermatology, Montreal General Hospital, McGill University Health Centre, QC, Canada
| | - Anastasiya Muntyanu
- 54473 Division of Dermatology, Montreal General Hospital, McGill University Health Centre, QC, Canada
| | - Moshe Ben-Shoshan
- Division of Allergy, Clinical Immunology and dermatology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Xun Zhang
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Lisa Iannattone
- 54473 Division of Dermatology, Montreal General Hospital, McGill University Health Centre, QC, Canada
| | - Elena Netchiporouk
- 54473 Division of Dermatology, Montreal General Hospital, McGill University Health Centre, QC, Canada
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