A new study published in the Feb. 24 online New England Journal of Medicine offers hope to sufferers of chronic hives. As reported in the New York Times, the asthma drug omalizumab, brand name Xolair, shows promise as an effective treatment for the debilitating itching that plagues one percent of the U.S. population.
“These results indicate that omalizumab could potentially be an important addition in the treatment of chronic idiopathic or spontaneous urticaria [hives], a disease that can have a significant impact on patients and can be challenging to manage,” said Tim Wright, Global Head of Development, Novartis, Pharmaceuticals in a news release. Omalizumab is being jointly developed by Novartis and Genentech.
Jonathan Bernstein, MD, a professor of medicine and an allergy specialist at the University of Cincinnati, who is not associated with the study, told the New York Times that it was well designed and that the results were encouraging.
“The drug is not a cure, but it will advance our ability to manage these patients,” said Bernstein.
Studies suggest that one in 1,000 people suffer from hives of idiopathic or unknown origin. Essentially this means the body acts as if it is allergic to something, but doctors cannot find a cause. For many patients with chronic hives, standard treatment with antihistamines or steroids is ineffective and life becomes a daily battle with unrelenting itch.
Omalizumab is thought to deactivate immunoglobulin E (IgE), a type of antibody that plays a crucial role in the allergic response. Patients with chronic hives may have higher levels of IgE, which binds to immune cells and causes an allergic itching reaction.
The study followed 323 patients with moderate to severe chronic idiopathic hives who did not respond to antihistamines. Researchers randomly assigned participants to receive a placebo injection, or 75 mg, 150 mg or 300 mg of omalizumab at four-week intervals over a period of 12 weeks. Participants were followed for 16 weeks after treatment stopped.
Patients who received the 150 mg injections experienced a 57 percent reduction in itching, while those treated with 300 mg had a 71 percent reduction. The group that received 75 mg had a 41 percent reduction in itching, which was not significant when compared with the 37 percent reduction experienced by the placebo group.
Omalizumab is approved for the treatment of severe allergic asthma under the brand name Xolair in the U.S., but is awaiting approval for treatment for chronic hives. Because the number of patients treated in the trial study was low and possible side effects include joint inflammation, pain, rash, fever or swollen lymph nodes, more study is needed to determine If Xolair is safe and who will experience the most benefit from the drug. And according to NBC News it is expensive -- $1,200 to $1,600 a dose.