Abstract：
Background: Chronic spontaneous urticaria (CSU) is a common disease with complex pathogenesis. Patients\' clinical characteristics and responses to treatment vary. Objective: We aimed to investigate the role of data obtained from routinely recommended tests in predicting the response to omalizumab, the only biologic agent approved for treatment, and in defining the clinical characteristics of the patients. Methods: A retrospective study of patients who started omalizumab treatment for CSU between 2015 and 2022 at the Department of Dermatology, Pamukkale University, was conducted. Response criteria were based on the urticaria control test, and patients with a urticaria control test score <12 at 6 months were considered treatment non-responders. Eosinophil and basophil counts, neutrophil-lymphocyte ratio (NLR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and total immunoglobulin E (IgE) levels of the patients were evaluated before treatment and at the sixth month of treatment. Results: A total of 23.1% of the patients were unresponsive to omalizumab. The response rate to the omalizumab treatment of the patients with a total IgE level ≤ 30 IU/L (n = 4 [5.7%]) was significantly lower than patients with total IgE level > 30 IU/L (n = 66 [94.3%]) (p = 0.015). The mean ± standard deviation SIRI levels were significantly higher in non-responders versus responders (1.53 ± 1.03 versus 1.15 ± 7.76; p = 0.026). Eosinophil counts positively correlated with basophil counts (r = 587; p < 0.001) and IgE levels (r = 0.290; p = 0.005) but a negative correlation was found with levels of NLR (r = -0.475; p < 0.001), SIRI (r = -0.259; p = 0.013), and SII (r = -0.285; p = 0.006). NLR levels were lower in CSU patients with atopy, than in those without atopy (1.9 ± 0.9 vs 2.9 ± 2.1, p = 0.022). Conclusion: We suggest that eosinopenia and high NLR levels are linked to autoimmune CSU. Predicting a poor response to omalizumab seems possible with total IgE levels < 30 IU/L and high SIRI levels.
摘要：
背景:慢性自发性荨麻疹(CSU)是一种常见病,发病机制复杂。患者的临床特征和对治疗的反应各不相同。目的：我们旨在研究从常规推荐的测试中获得的数据在预测奥马珠单抗反应中的作用。唯一被批准用于治疗的生物制剂，并确定患者的临床特征。方法：2015年至2022年在皮肤科开始奥马珠单抗治疗CSU的患者的回顾性研究，帕穆卡莱大学，进行了。反应标准基于荨麻疹控制试验，并且在6个月时荨麻疹控制测试评分<12的患者被认为是治疗无应答者。嗜酸性粒细胞和嗜碱性粒细胞计数,中性粒细胞-淋巴细胞比率（NLR），全身免疫炎症指数（SII），全身炎症反应指数（SIRI），在治疗前和治疗第6个月评估患者的总免疫球蛋白E（IgE）水平。结果：23.1％的患者对奥马珠单抗无反应。总IgE水平≤30IU/L（n=4[5.7％]）的患者对奥马珠单抗治疗的反应率显着低于总IgE水平>30IU/L的患者（n=66[94.3％]）（p=0.015）。平均±标准偏差SIRI水平在非应答者中显著高于应答者(1.53±1.03对1.15±7.76;p=0.026)。嗜酸性粒细胞计数与嗜碱性粒细胞计数（r=587；p<0.001）和IgE水平（r=0.290；p=0.005）呈正相关，但与NLR水平呈负相关（r=-0.475；p<0.001）。SIRI（r=-0.259；p=0.013），和SII(r=-0.285;p=0.006)。CSU特应性患者的NLR水平较低，高于无特应性患者（1.9±0.9vs2.9±2.1，p=0.022）。结论：我们认为嗜酸性粒细胞减少和高NLR水平与自身免疫性CSU有关。在总IgE水平<30IU/L和高SIRI水平的情况下，预测对奥马珠单抗的反应差似乎是可能的。
