Treatment of patients with evidence of mast cell-mediated itch in the absence of hives with omalizumab.

Kelsey L Auyeung, Brian S Kim
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Abstract

Purpose: The presence of wheals or hives has been viewed as a hallmark symptom of urticaria, a highly debilitating disease. This study explores our experience with omalizumab in patients with apparent mast-cell mediated pruritus in the absence of hives.

Materials and methods: This is a retrospective case series examining all patients with mast cell-mediated pruritus in the absence of hives from April 2022 to May 2024 at a tertiary referral clinic at Icahn School of Medicine at Mount Sinai in New York. Peak pruritus-numerical rating scale (PP-NRS) itch score changes over time were recorded and analyzed.

Results: Six patients (67% women; mean [SD] age, 47.67 [13.52] years) were included in the analysis. The median [IQR] pruritus PP-NRS itch score before omalizumab injection was 9 [6 - 10] and the final median [IQR] PP-NRS itch score was 2.5 [0 - 5]. The mean [SD] reduction in the PP-NRS itch score was 6 [3.16].

Conclusions: This study suggests that patients with evidence of mast cell-mediated pruritus can be identified based on clinical features and may benefit from omalizumab therapy.

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用奥马珠单抗治疗有肥大细胞介导的瘙痒证据但无荨麻疹的患者。
目的:喘息或荨麻疹的出现一直被视为荨麻疹的标志性症状,而荨麻疹是一种极易使人衰弱的疾病。本研究探讨了我们使用奥马珠单抗治疗明显由肥大细胞介导但无荨麻疹的瘙痒症患者的经验:这是一项回顾性病例系列研究,研究对象是 2022 年 4 月至 2024 年 5 月期间在纽约西奈山伊坎医学院三级转诊诊所就诊的所有无荨麻疹的肥大细胞介导的瘙痒症患者。记录并分析了瘙痒峰值数字评分量表(PP-NRS)瘙痒评分随时间的变化:六名患者(67% 为女性;平均 [SD] 年龄为 47.67 [13.52] 岁)参与了分析。注射奥马珠单抗前的瘙痒 PP-NRS 评分中位数[IQR]为 9 [6 - 10],最终的 PP-NRS 评分中位数[IQR]为 2.5 [0 - 5]。PP-NRS 瘙痒评分的平均[标度]降低幅度为 6 [3.16]:这项研究表明,有证据表明肥大细胞介导的瘙痒症患者可以根据临床特征识别出来,并可能从奥马珠单抗治疗中获益。
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