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Creighton Professor's Research Could Bring Relief for Chronic Hives

The New England Journal of Medicine has published new research by Thomas B. Casale, M.D., professor of medicine and microbiology and immunology and chief of allergy/immunology at Creighton University School of Medicine, suggesting a new treatment approach for patients who are unable to find relief for chronic hives.

Omalizumab is an immunomodulator medication, which means it acts by directly changing the behavior of the immune system. While it is currently used to treat severe allergic asthma in those who are 12 years of age and older, a late-breaking abstract that Casale presented at the 2013 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) and published in the New England Journal of Medicine Feb. 24, found that omalizumab also appears safe and effective in the treatment of patients suffering from chronic hives who are not successfully treated with antihistamines.

"Many times the treatment of hives is successful with oral antihistamines that control the itch and recurrence of the rash. Yet there are patients with hives that last for long periods of time and are idiopathic, or without an identifiable cause," Casale said. "In some of these chronic hives patients, antihistamines are not successful, but from our clinical trials we're seeing that omalizumab is safely able to provide relief when compared with a placebo."

Researchers studied the safety and effectiveness of this use of the drug on 323 patients between the ages of 12 and 75, with moderate to severe chronic hives, who were not adequately treated with antihistamines. In the randomized, double-blind, placebo-controlled study, those patients who received omalizumab reported a reduction in itch severity sooner than those taking a placebo. Those receiving omalizumab also experienced a decrease in the number of hives throughout the duration of the study.

"From the trial results, omalizumab appears rapidly effective and well-tolerated in patients with chronic hives that don?t respond to licensed doses of antihistamines," Casale said. "The results of two other Phase III trials should be available later this year and will help in defining the ultimate efficacy and safety of omalizumab for chronic hives, as well as the most appropriate dosing regimen."

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,700 members in the United States, Canada and 60 other countries.