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Sequential Combined Therapy With Omalizumab and Rituximab: A New Approach to Severe Atopic Dermatitis

dc.contributor.authorSánchez Ramón, Silvia María
dc.contributor.authorEguíluz-Gracia I,
dc.contributor.authorRodríguez-Mazariego ME
dc.contributor.authorParavisini A
dc.contributor.authorZubeldia Ortuño, José Manuel
dc.contributor.authorGil-Herrera J
dc.contributor.authorFernández-Cruz Pérez, Eduardo
dc.contributor.authorSuárez-Fernández R
dc.date.accessioned2025-01-23T08:33:28Z
dc.date.available2025-01-23T08:33:28Z
dc.date.issued2012-12-05
dc.description.abstractBackground: Atopic dermatitis (AD) is a common chronic skin disease, and a significant percentage of AD patients have severe forms. Inflammation based on type 2 helper T cells (T(H)2), autoantibodies, and CD8+ T cells could play a relevant role in this disease. When the patient requires systemic immunosuppressors for disease control, side effects are frequent. We propose a sequential therapeutic strategy with 2 monoclonal antibodies, omalizumab (anti-immunoglobulin [Ig] E) and rituximab (anti-CD20), which might induce clinical benefit with few side effects in selected individuals with AD. Methods: We report 6 cases of severe AD refractory to conventional therapy. The patients underwent sequential switch therapy with omalizumab and rituximab. Clinical response was assessed by means of the decrease in body surface affected. Immunological parameters and side effects were also monitored. Results: Four patients received omalizumab before a high-dose cycle of rituximab. In the case of recurrences, either low-dose cycles of rituximab or omalizumab were administered. A long-term clinical benefit was observed in 3 out of 4 patients. Two patients first received high-dose rituximab followed by either low-dose rituximab or omalizumab, and one of them achieved a response at 17 months. No severe side effects were recorded. Serum IgE level and B-cell counts decreased with therapy, the latter returning to baseline levels 10 to 11 months after treatment. Specific antibody responses remained protective during the study. Conclusions: With our proposed switch therapy, 4 out of 6 patients achieved a dramatic clinical improvement. This novel strategy targets different arms of the immune response and might be a good alternative for patients with severe AD.
dc.description.departmentDepto. de Medicina
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.essn1698-0808
dc.identifier.pmid23967758
dc.identifier.relatedurlhttps://pubmed.ncbi.nlm.nih.gov/23967758/
dc.identifier.urihttps://hdl.handle.net/20.500.14352/115714
dc.issue.number3
dc.journal.titleJournal of Investigational Allergology and Clinical Immunology
dc.language.isoeng
dc.page.final196
dc.page.initial190
dc.publisherESMON
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.cdu616.5-002
dc.subject.keywordtopic dermatitis
dc.subject.keywordOmalizumab
dc.subject.keywordRituximab
dc.subject.keywordAutoimmunity.
dc.subject.keywordAllergy.
dc.subject.ucmAlergología
dc.subject.unesco3201.06 Dermatología
dc.titleSequential Combined Therapy With Omalizumab and Rituximab: A New Approach to Severe Atopic Dermatitis
dc.typejournal article
dc.type.hasVersionAM
dc.volume.number23
dspace.entity.typePublication
relation.isAuthorOfPublicationbea59590-c16b-4e29-b8d6-d7b2133b4533
relation.isAuthorOfPublication31d939f5-0cc2-4cea-8f6b-aad05509bbbf
relation.isAuthorOfPublicationbc1e21d4-e192-43a6-8a94-63a74d8f378f
relation.isAuthorOfPublication.latestForDiscoverybea59590-c16b-4e29-b8d6-d7b2133b4533

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