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Omalizumab in the treatment of adult patients with mastocytosis: A systematic review
Author(s) -
Jendoubi Fatma,
Gaudenzio Nicolas,
Gallini Adeline,
Negretto Mathilde,
Paul Carle,
Bulai Livideanu Cristina
Publication year - 2020
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.13592
Subject(s) - omalizumab , medicine , systemic mastocytosis , tolerability , cutaneous mastocytosis , retrospective cohort study , anaphylaxis , adverse effect , randomized controlled trial , cohort , pediatrics , allergy , surgery , immunoglobulin e , immunology , disease , antibody
Background Mastocytosis is associated with mast cell (MC) mediator‐related symptoms for which limited therapies are available. Objective Our aim was to assess the efficacy and safety of omalizumab in the treatment of MC mediator‐related symptoms in adult patients with mastocytosis. Results We identified one multi‐centre retrospective cohort study (39 patients), one retrospective cohort study (13 patients), 4 case series and 10 case reports. No published controlled randomized study was identified. We included 69 patients (13 patients with cutaneous mastocytosis and 56 with systemic mastocytosis). The mean age was 48 years. Omalizumab maintenance dose was 300 mg for the majority of patients. The mean duration of treatment was 17 months. Treatment led to a tolerability of venom immunotherapy and to a complete resolution of severe reactions in all patients with post‐honeybee sting anaphylaxis. Complete resolution of idiopathic anaphylaxis episodes was noted in 84% of the patients. Complete resolution of palpitations, gastrointestinal, cutaneous, neuropsychiatric, respiratory and musculoskeletal symptoms was observed at a rate of 43%, 29%, 27%, 11%, 9% and 0%, respectively. Efficacy was maintained for the entire duration of the treatment in all but four responders. Adverse events were reported for 13 patients. Conclusions and Clinical Relevance Omalizumab appears to prevent some life‐threatening reactions associated with mastocytosis and may be a good option to treat the associated symptoms. However, the evidence relied upon is observational, uncontrolled and from a small number of patients. A randomized controlled trial is needed to better understand the place of omalizumab in mastocytosis treatment.