Cailin Conner

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A study in Allergy and Asthma Proceedings suggests that low total immunoglobin E (IgE) levels and high systemic inflammation response index (SIRI) levels are predictors of poor response to omalizumab in patients with chronic spontaneous urticaria (CSU), while eosinopenia and a high neutrophil-lymphocyte ratio (NLR) may indicate autoimmune disease.
To investigate which factors predict a favorable or poor response to omalizumab in patients with CSU, a retrospective study was conducted.
The study encompassed patients who started omalizumab therapy between 2015 and 2022. The researchers evaluated clinical and laboratory parameters before and after 6 months of treatment, using the Urticaria Control Test (UCT) to assess treatment efficacy. Patients with a UCT score of less than 12 at 6 months were classified as nonresponders.
Overall, 23.1% of patients did not respond to omalizumab treatment. Patients with a total IgE level of 30 IU/L or lower had a significantly lower response rate to omalizumab compared with those with higher IgE levels (5.7% vs 94.3%; P=.015).
Additionally, SIRI was significantly higher in nonresponders compared with responders (1.53 vs 1.15; P=.026).
The investigators also examined correlations between various laboratory parameters. Eosinophil counts were positively correlated with basophil counts and total IgE levels. However, negative correlations were observed between eosinophil counts and NLR, SIRI, and the systemic immune inflammation index. Furthermore, NLR levels were found to be lower in patients with atopy compared with those without (1.9 vs 2.9; P=.022).
“We suggest that eosinopenia and high NLR levels are linked to autoimmune CSU. Predicting a poor response to omalizumab seems possible with total IgE levels &lt;30 IU/L and high SIRI levels,” the researchers concluded.
Source: <a href="https://www.ingentaconnect.com/content/ocean/aap/2024/00000045/00000004/art00012" target="_blank" rel="noopener">Allergy and Asthma Proceedings</a>

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Low IgE, High Systemic Inflammation Response Index May Predict Poor Response to Omalizumab

Chronic Spontaneous Urticaria

In patients with chronic spontaneous urticaria, low total immunoglobin E levels and high systemic inflammation response index levels are predictors of poor response to omalizumab.

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