Study shows asthma drug is 'magic bullet' for chronic itching and hives
An asthma drug is offering hope to those suffering from inexplicable chronic itching, according to a recent report published in the New England Journal of Medicine.
Xolair, known generically as omalizumab, is a monoclonal antibody approved to treat allergic asthma. In a trial study in Berlin, a monthly injection of the drug was found to significantly reduce hives and itchiness in patients who had not responded to traditional antihistamine medications.
“This is the magic bullet that patients have been waiting for the last 40 years,” said the study’s lead author, Dr. Marcus Maurer, a professor of dermatology and allergy in Berlin.
If approved for the treatment of chronic itching and hives, omalizumab could bring relief to those who suffer from chronic idiopathic urticaria, which causes hives and itchiness for no known reason.
Studies indicate that approximately one in 1,000 people suffer from the condition. So far, the only drugs approved to treat it are non-sedating antihistamines, which fewer than half of patients respond to, prompting doctors to increase the dosage above the approved amount or prescribe off-label medications, such as steroids, which can cause serious side effects.
Researchers in the study enrolled 323 patients with moderate to severe chronic idiopathic hives who did not respond to antihistamines. The patients were then randomly assigned to receive one of four options: a monthly injection of 75 milligrams, 150 milligrams or 300 milligrams of omalizumab, or a placebo for 12 weeks. After treatment stopped, they were followed for four months.
The results found that patients who received 150 milligrams of the drug had a 57 percent reduction in itching, compared to a 71 percent reduction in those treated with 300 milligrams – a significant improvement compared to the placebo group, which had a 37 percent reduction in itching, and both groups receiving the higher doses also had less swelling and reduced severity of hives.
Meanwhile, those who received only 75 milligrams had 41 percent less itching, which was not statistically significant compared with the placebo group.
Researchers concluded that the asthma drug omalizumab successfully diminished clinical symptoms and signs of chronic itching and hives in patients who had remained symptomatic despite the use of approved doses of H1-antihistamines.
SOURCE: New England Journal of Medicine (N Engl J Med 2013; 368:924-935 March 7, 2013 DOI: 10.1056/NEJMoa1215372)