Patients with urticaria vary with regard to presentation, response

HOUSTON — Clinicians who treat patients with urticaria should be wary about the differences in clinical trajectories in patients when diagnosing and treating the disease, according to a presenter at the American Academy of Allergy, Asthma and Immunology Annual Meeting.

“Evidence-based medicine is crucial, yet we treat individuals and individuals don’t always follow the mean,” Stephen C. Dreskin, MD, PhD, FAAAAI, director of the University of Colorado Allergy, Immunology and Rheumatology Practices, said during a plenary session presentation.

Patients have varied presentations and clinical trajectories, and their response to medication and time to resolution can differ, Dreskin said.

Dreskin referenced a study that included 12 patients treated with omalizumab (Xolair; Roche/Genentech, Novartis) 150 mg daily or placebo for 16 weeks. Results showed 58% of all participants had control of chronic spontaneous urticaria, while the remaining participants had very little control.

“That kind of data gets left out or is hard to see when you have these large population studies that show the standard area of means, so the devil is in the details,” he said.

Considering the differences in clinical trajectories, there are bound to be differences in the effectiveness of medications, Dreskin said.

“Is the glass 60% full or is it 40% empty? I think that both things are true,” he said. “We have to appreciate that we have medications that can help perhaps 60% of our patients but [also] recognize that there are still 40% of our patients who represent an unmet need.” – by Ryan McDonald

Reference:

Dreskin SC, et al. Plenary 3101. Presented at: American Academy of Allergy, Asthma and Immunology Annual Meeting; Feb. 20-24, 2015; Houston.

Disclosure: Dreskin reports grant support from Genentech and the National Institutes of Health, as well as consultant roles with AAAAI and ARTrust.