D2.270 - Clinical and Laboratory predictors of treatment response among adult Egyptian patients with Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is a chronic disease with debilitating symptoms including severe pruritus, wheals and angioedema causing a disruption of daily activities. Different studies indicate variable responses to treatment.We aimed to identify clinical features and laboratory predictors of response of various treatment options in chronic spontaneous urticaria

A cross sectional study was conducted on 148 adult patients with CSU, all patients were subjected to detailed history, body mass index (BMI) measurement, physical examination, Urticaria activity score7 (UAS-7) and (UCT) before and after treatment, CBC, Total IgE, Anti Peroxidase antibodies (AntiTPO), ESR and CRP. All patients received anti histamines while 24 received omalizumab.

Females constituted 74.1% of the study with median ±SD age 39.84 ± 12.89 years old. 73% had angioedema,18.4% received NSAIDs with no history of atopy nor family history of atopy 42.9%, 75.5% respectively. delayed pressure urticaria was common in CSU 37.4%. the most reported exacerbators were stress and pesudoallergin diet 87.1%, 43.5% respectively. 34% patients failed to response to antihistamines with high BMI, presence of angioedema, associated psychiatric illness and high CRP being of significance 0.043, 0.033, 0.004,0.005 respectively. 11 patients showed compete response to omalizumab while nine patients were non responders. No clinical nor Laboratory tests were of significance between both groups. High BMI was the only significant factor between early and late responders for omalizumab p< 0.001.

High BMI, presence of angioedema, associated psychiatric illness and high CRP were predictors for poorer response to anti histamines treatment in CSU patients while high BMI was the only predictor for late response to omalizumab. The evaluated laboratory tests and the clinical characteristics did not demonstrate predictive value for omalizumab treatment response.