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The efficacy of omalizumab in Cutaneous Mastocytosis: A case series
Author(s) -
Hinojosa Tiffany,
Lewis Daniel J.,
Vangipuram Ramya,
Safeer Laraib,
Mui Uyen Ngoc,
Haley Christopher,
Konoplev Sergej,
Tyring Stephen K.
Publication year - 2019
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12848
Subject(s) - omalizumab , medicine , dermatology , cutaneous mastocytosis , systemic mastocytosis , immunoglobulin e , immunology , antibody , mast cell
Background : Mastocytosis describes a heterogeneous group of disorders arising from a clonal proliferation of mast cells. Given the lack of curative treatments for the cutaneous form, there is a significant need for superior therapies. Omalizumab is a recombinant DNA‐derived humanized IgG monoclonal antibody that selectively binds to human immunoglobulin E (IgE). It represents a potential treatment for the management of cutaneous mastocytosis, which currently has no standard treatment. Methods : Two patients were treated with subcutaneous omalizumab 300 mg every 4 weeks. Discussion : Patient 1 experienced 50% reduction in cutaneous infiltration and moderate improvement in pruritus. Patient 2 underwent 90% complete clearance of cutaneous lesions and reported full resolution of pruritus. The median duration of treatment was 24 weeks and time to response was 8 weeks. No significant changes in tryptase levels were observed. Both patients experienced injection site reactions. Conclusion : We provide evidence from two cases supporting the efficacy of IgE‐mediated therapy in the treatment of cutaneous mastocytosis. Even at a higher‐than‐standard dose (300 mg vs. 150 mg), the drug was well‐tolerated. As we await the results of pivotal clinical trials, omalizumab appears to be a promising treatment option in patients with cutaneous mastocytosis unresponsive to traditional therapies.

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