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Amelioration of patients with chronic spontaneous urticaria in treatment with vitamin D supplement.

ABSTRACT: Background:Spontaneous urticaria is a common allergic skin condition affecting 0.5-1% of individuals and may burden on health care expenditure or may be associated with remarkable morbidity. Aim:In this study, we measured the effect of vitamin D supplementation in patients with a diagnosis of CSU. Furthermore, quality of life and cytokine changes were evaluated. Methods:The clinical trial was conducted on 20 patients with idiopathic chronic urticaria. Vitamin D was administered orally for 8 weeks and disease activity was measured pre- and post-treatment using USS and DLQI. On the other hand expressions of IL-17, IL-10, Foxp3, and TGF-? by Real-time RT-PCR were assessed. Results:USS questionnaire showed that severity of idiopathic urticaria after the intervention, which compared with the first day reached a significant 55% reduction. The DLQI quality of life questionnaire 2 months after treatment showed 55% improvement. Along with the significant improvement of clinical symptoms, use of vitamin D increase FOXP3 gene expression and downregulation of IL-10, TGF-B, and FOXP3, IL-17, but these changes were not statistically significant. Limitation:These might happen due to lack of enrolled population in the investigation. Conclusion:Vitamin D can be used along with standard medical care and it's a safe and cost-effective method for the treatment of chronic urticaria with deficiency of vitamin D.

SUBMITTER: Ariaee N

PROVIDER: S-EPMC5740857 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Amelioration of patients with chronic spontaneous urticaria in treatment with vitamin D supplement.

Ariaee Nazila N Zarei Shima S Mohamadi Mojgan M Jabbari Farahzad F

Clinical and molecular allergy : CMA 20171222

<h4>Background</h4>Spontaneous urticaria is a common allergic skin condition affecting 0.5-1% of individuals and may burden on health care expenditure or may be associated with remarkable morbidity.<h4>Aim</h4>In this study, we measured the effect of vitamin D supplementation in patients with a diagnosis of CSU. Furthermore, quality of life and cytokine changes were evaluated.<h4>Methods</h4>The clinical trial was conducted on 20 patients with idiopathic chronic urticaria. Vitamin D was administ ...[more]

PMID: 29299028

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Project description:BackgroundChronic urticaria (CU) is a common skin disorder, which can be further divided into chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). Omalizumab is effective and safe for difficult-to-treat CSU based on clinical trials. However, there are limited data comparing the therapeutic effect of omalizumab for patients with CSU, CIndU, and CSU plus CIndU. Meanwhile, there is still no reliable predictor for treatment response or relapse. Our study was conducted to collect real-world clinical data on omalizumab treatment in patients with CSU, CIndU, and both.MethodsThis was an observational, retrospective chart review of patients with CU initiating omalizumab treatment between February 2018 and May 2020 (maximum 28 months follow-up).ResultsA total of 138 patients were included, 87 with CSU alone, 33 with different forms of CIndU, and 18 with both. A total of 87.0% (n = 120/138) of the CU patients responded to omalizumab therapy, among which 65.2% (n = 90/138) of the patients showed complete response and 21.7% (n = 30/138) of the patients showed partial response. The therapeutic effect and speed of onset of effect for omalizumab were comparable among patients with CSU, CIndU, or both. Autologous serum skin test (ASST)-positive patients were more likely to show a slow response to omalizumab therapy ( P = 0.043). Non-responders had lower baseline total IgE levels (35.0 vs 121.5 kU/L, P < 0.001). The proportion of patients with low total IgE levels in non-responders was significantly higher than that of responders (61.1% vs. 14.5%, P < 0.001). Also, more non-responder patients had elevated thyroid autoantibodies than responders (50.0% vs. 23.0%, P = 0.041). The median ratio of serum IgG-anti-TPO to serum total IgE in non-responders was significantly higher compared with responders (1.22 vs. 0.09, P < 0.001). Non-responders also had shorter treatment periods (4.5 vs 6.0 months, P = 0.035) compared with responders. Two of 3 patients (67.4%, n = 29/43) experienced relapse after ceasing omalizumab therapy. These patients had longer disease durations (52.0 vs. 15.0 months, P = 0.007) and higher baseline total IgE levels (179.9 vs. 72.5 kU/L, P = 0.020) than patients who did not relapse. We reinitiated omalizumab treatment for 10 relapsed patients, all of them reported a rapid response after the first injection within the first 4 weeks of retreatment.ConclusionOmalizumab is highly effective in patients with difficult-to-treat CSU, CIndU, or both. Responders tend to have unique immunological features and longer treatment periods. Patients with higher baseline total IgE levels and longer disease durations are more likely to experience rapid relapse after discontinuation of omalizumab.

Dataset Information

Amelioration of patients with chronic spontaneous urticaria in treatment with vitamin D supplement.

Publications

Amelioration of patients with chronic spontaneous urticaria in treatment with vitamin D supplement.

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