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Master Thesis

Urticaire chronique spontanée traitée par Omalizumab : traitement personnalisé dans une file active française de 64 patients entre 2013 et 2016

Abstract : In clinical studies, efficacy and tolerance of Omalizumab to treat severe forms of Chronic Spontaneous Urticaria (CSU), has been well established. The licensed dose is 300 mg every 4 weeks. Yet few data extracted from real life analysis exist. Our goal is to assess feasibility and relevance of such personalized Omalizumab treatments, for patients with severe CSU, followed in Grenoble Alpes University Hospital. A retrospective, monocentric study (Grenoble Alpes University Hospital) of a French Cohort of patients with CSU resistant to fourthfold dose of anti-histamins treated with Omalizumab between May 2013 and January 2016. Our analysis aimed to evaluate the quality and delay of treatment responses, treatment duration and patients’ tolerance to Omalizumab. Treatment efficacy was measured from clinical data: response to the treatment (scores Cu-QoL, AE-QoL, UCT, AAS28 et UAS7) and the interval between 2 injections was individually tailored. Results : 64 patients (including 51 women), aged between 16 and 89, suffering from severe CSU, were cared for over an average period of 32 months. 81% of these patients developed angioedema because of superficial urticaria. The disease’s average length fluctuated between 6 months to 15 years. 92% of patients taking Omalizumab completely responded to the treatment after 6 months, 60% after the second injection, 6% partially responded. A complete response is defined as an upgrade in quality of life above 80 %, followed by UAS=0 and AAS=0. On average, the Omalizumab intake lasted between 2 and 38 months. In terms of time interval between two injections, it fluctuated between 2 and 16 weeks. It was decided to put a halt to the treatment in cases for which patients did not respond after 6 months. Verdicts to stop Omalizumab were never a result of secondary symptoms. Only one patient stopped his own treatment without consulting medical advice, and had not relapsed a year later. 37% of patients showed non-severe adverse events which disappeared after several injections. In real life, out of 64 patients, individual and personalized treatment intervals when prescribing Omalizumab, allowed for a response rate far superior to clinical tests, with a clear progress with regard to patients’ quality of life.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01812473
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Catherine Desbleds-Mansard. Urticaire chronique spontanée traitée par Omalizumab : traitement personnalisé dans une file active française de 64 patients entre 2013 et 2016. Médecine humaine et pathologie. 2016. ⟨dumas-01812473⟩

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