Uso de omalizumabe em dose terapêutica de 150mg no tratamento da urticária crônica espontânea: Revisão sistemática de literatura

Abstract

Introduction: Urticaria is one of the pathologies that most negatively interferes with daily activities and quality of life. It is characterized by the appearance of pruritic skin rashes, erythema and edema, lasting a few hours, without leaving residual lesions. When it occurs daily for more than six weeks, it is considered as chronic urticaria, which may be spontaneous or induced. The cutaneous symptoms are secondary to the activation of mast cells that mainly release histamine. Treatment of chronic spontaneous urticaria involves the use of H1 antihistamines up to four times the usual dose. When no improvement occurs with the use of these medicinal products, current therapeutic guidelines recommend the combination with omalizumab, an anti-IgE monoclonal antibody, followed by the use of cyclosporine. The currently recommended dose of omalizumab is 300mg subcutaneously every 04 weeks, but there are reports of patients responding at a dose of 150mg. Objective: To verify the data in the literature regarding the use of omalizumab in the dose of 150 mg for the treatment of chronic spontaneous urticaria. Methodology: Systematic review by searching the PubMed, SciELO and Lilacs databases of articles published since the year 2000. The descriptors for this research were used in Boolean or non, Portuguese, English and Spanish. Results: All articles used for this analysis demonstrated the efficacy of omalizumab in doses of 150mg and 300mg, and the 300mg dose had better results. Adverse effects have been reported in both dosages, being more frequent in the 300mg dose, despite this, omalizumab has been shown to be effective and safe in the treatment of UCE. It was not possible to determine the profile of the patients benefiting using the 150 mg dose in the treatment of ECU. Conclusion: Although the studies analyzed in this study demonstrated efficacy and safety in the use of the 150mg dose of omalizumab, these results are still incipient due to the small number of studies and the lack of more studies that can corroborate the use of this dose. Many authors have argued that this lack of studies is due, precisely, to the high financial cost of treatment.