Two large trials, DREAM and MENSA have found IL-5 therapy with mepolizumab to lower risk of exacerbation in patients with asthma with an eosinophilic phenotype.
A randomized double-blind study evaluated the effectiveness of anti-IgE therapy with Xolair for patients with chronic hives. It included 68 patients with severe hives. The diagnosis were idiopathic hives in 61 patients, cold induced hives in 6 and urticarial vasculitis in 1. All patients were steroid dependent. All received Xolair at 150mg per month and were followed for 25 months. Remission rates were documented as 69-79% at up to 25 months of follow-up. Patients used a urticaria-7day urticaria activity score (UAS-7). Scores decreased from 24.4 to 2.2 while medication scores decreased from 13.3 to 3. All cold urticaria patients became asymptomatic with improvement on cold stimulation testing. There were no significant adverse events. Xolair is a very safe and effective therapy for chronic intractable hives with the prospect of remission.
We have Xolair available through our office. Our practice patients have found relief of their hives with their first injection. We now have sample injections available as a trial for patients with chronic urticaria.
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