Omalizumab and new therapeutic targets in chronic spontaneous urticaria

Omalizumab and new therapeutic targets in chronic spontaneous urticaria

Ana S. Pereira 1, Joana Xará 2, Duarte Flor 3, Margarida Gonçalo 4, 5

1 Serviço de Dermatovenereologia, Unidade Local de Saúde de Almada-Seixal, Almada, Portugal; 2 Department of Dermatology, University Hospital, Coimbra Local Health Unit and Faculty of Medicine, Coimbra, Portugal; 3 Department of Dermatology, University Hospital, Local Health Unit of Coimbra, Coimbra, Portugal; 4 Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 5 Dermatology Clinic, Coimbra University Hospital, Coimbra, Portugal

Ana S. Pereira, Joana Xará, Duarte Flor, Margarida Gonçalo

La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.

*Correspondence: Ana S. Pereira, Email not available

Abstract

Chronic spontaneous urticaria (CSU) is a common and distressing skin disease characterized by itchy wheals, angioedema, or both. There is currently no cure for CSU and symptomatic treatment is often insufficient. Omalizumab, a humanized anti-immunoglobulin (Ig) E monoclonal antibody, remains the only biological drug licensed for CSU, almost a decade after its approval. However, growing knowledge of the pathophysiological mechanisms of this disease has led to recent advances in its treatment, with several drugs in investigation both in pre-clinical and clinical settings. These include biologicals, such as dupilumab (anti-IL-4Rα), secukinumab (anti-IL-17), tezepelumab (anti-TSLP), ligelizumab (anti-IgE), lirentelumab (anti-Siglet 8), and barzovolimab (anti-cKIT), as well as “small molecules,” such as Bruton tyrosine kinase (BTK) inhibitors (remibrutinib) and a Mas-related G protein-coupled receptor X2 (MRGPRX2) antagonist. Here, we review the current and future therapeutic options for CSU, based on what is known about the pathogenesis of the disease.

Keywords:  Chronic spontaneous urticarial. Mast cells. Omalizumab. Novel biologics. Small molecules.

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