Omalizumab therapy in atopic dermatitis: depletion of IgE does not improve the clinical course – a randomized, placebo‐controlled and double blind pilot study
Abstract
Background Our understanding of the pathogenic role of IgE in atopic dermatitis is incomplete. We asked whether blocking free IgE would alter the course of the disease. Patients and methods We administered either omalizumab, a humanized monoclonal mouse antibody against IgE, or placebo subcutaneously for 16 weeks to 20 atopic dermatitis patients and measured immunological and clinical disease parameters. Results Omalizumab (I) reduced free serum IgE, (II) lowered surface IgE and FcɛRI expression on different peripheral blood mononuclear cells, (III) reduced the saturation of FcɛRI with IgE, (IV) increased the number of free FcɛRI and (V) lowered the number of IgE+, but not of FcɛRI+ cells in skin. The in vivo relevance of these results is evidenced by the increase in the threshold allergen concentration required to give a type I hypersensitivity reaction in the titrated skin test. While not significantly altering the clinical disease parameters, omalizumab treatment led to an improvement of the atopy patch test results in single patients, i.e. an eczematous reaction upon epicutaneous allergen challenge. Conclusions The interference with immediate and delayed type skin tests may imply that a therapeutic benefit of omalizumab treatment, if present at all, would be seen in patients with acute rather than chronic forms of the disease.
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Omalizumab failed to show convincing results in proof-of-concept studies and single cases.
“strategies aimed at depleting IgE with the anti-IgE biologic omalizumab failed to show convincing results in proof-of-concept studies and single cases107,108.”
From Atopic dermatitis: an expanding therapeutic pipeline for a complex disease (2022) · cites this paper as [107]
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- Authors
- Heil, P. M., Maurer, D., Klein, B., Hultsch, T., & Stingl, G.
- Affiliations
- Medical University of Vienna (AT)
- Johannes Gutenberg University Mainz (DE)
- Venue
- JDDG: Journal der Deutschen Dermatologischen Gesellschaft
- Publisher
- Wiley
- Published
- 2010-11-25
- Volume
- 8
- Issue
- 12
- Pages
- 990-998
- ISSN
- 1610-0379 (ISSN-L)
- 1610-0387
- OpenAlex
- W1512818159
- Cited by
- 197
- References
- 38
- Citations by year
- 2026: 1 · 2025: 11 · 2024: 3 · 2023: 10 · 2022: 6 · 2021: 14 · 2020: 10 · 2019: 14 · 2018: 12 · 2017: 19 · 2016: 24 · 2015: 24 · 2014: 13 · 2013: 15 · 2012: 16
- FWCI
- 13.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JDDG Journal der Deutschen Dermatologischen Gesellschaft (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Keywords
- omalizumab, atopic dermatitis, IgE, FcεRI, immediate hypersensitivity, atopy patch test, chronic atopic dermatitis
- MeSH terms
- Omalizumab, Adolescent, Adult, Antibodies, Anti-Idiotypic, Antibodies, Monoclonal, Dermatitis, Atopic, Double-Blind Method, Female, Humans, Immunoglobulin E, Injections, Subcutaneous, Male, Middle Aged, Pilot Projects, Skin Tests, Placebo Effect, Treatment Outcome, Anti-Allergic Agents, Young Adult, Antibodies, Monoclonal, Humanized
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