Efficacy of omalizumab monotherapy in the management of atopic dermatitis

Background:Omalizumab is a unique biological therapeutic drug licensed for the treatment of atopic patients with moderate to severe persistent allergic asthma with a serum IgE ranging from 30 to 700 IU/ml. This study was performed to examine the efficacy of omalizumab for the treatment of atopic dermatitis, a disease with significant morbidity. Methods:We report the case of three young Caucasian men (16, 18 and 24 years old) who presented with chronic severe atopic dermatitis that only responded to oral corticosteroids. Failed treatments for these patients included topical corticosteroids, topical tacrolimus, oral prednisone, oral antibiotics and oral antihistamines. Only oral corticosteroids provided significant relief. All three patients had also moderate to severe persistent allergic asthma. All three patients had increased serum immunoglobulin E (IgE) levels: 532 IU/ml, 11.860IU/ml and 13.340IU/ml respectively (reference range, 11-210 IU/ml). All three patients received omalizumab a humanized monoclonal anti-IgE antibody currently indicated for patients 12 years and older with moderate to severe persistent asthma, administered suncutaneously, in a total dose of 450mg every 15 days. Atopic dermatitis severity was assessed at 0, 1, 3, 6 months with SCORAD. Results:All the three patients responded to a 12-week course of omalizumab, with significant improvement of their atopic dermatitis symptoms. No adverse events were reported throughout the course of treatment. Conclusion:We suggest that omalizumab may have a role in the treatment of atopic dermatitis in the adult population and further studies are needed to establish its therapeutic effect.