Effect of Omalizumab Therapy on Coagulation Parameters and Total Immunoglobulin E Levels in Patients with Chronic Idiopathic Urticaria and Bullous Pemphigoid

Objective: The aim of this study is to assess the impact of omalizumab on coagulation biomarkers and immunoglobulin E (IgE) levels in chronic idiopathic urticaria/chronic spontaneous urticaria (CIU/CSU) and bullous pemphigoid (BP) patients. Methods: Medical records of 31 CIU/CSU and 16 BP patients were reviewed according to the inclusion and exclusion criteria. Laboratory parameters for coagulation status and IgE levels at baseline and in the first 12-week period of omalizumab therapy were retrieved and analysed in the light of clinical response to the treatment. Results: At baseline, in CIU/CSU patients, IgE levels were significantly higher in responders [184.5 IU/mL (62-307 IU/mL)] than non-responders [25.6 IU/mL (10.8-30.2 IU/mL)] (p=0.021). During the first 12 weeks of omalizumab therapy, a dramatic decrease in D-dimer levels was observed in serial measurements of CIU/CSU (p=0.001) and also BP patients (p=0.017). Total IgE levels were increased after omalizumab usage in all study groups (p=0.003) and elevation of IgE levels was found significant for CIU/CSU but not for BP (p<0.001, p=0.278, respectively). Conclusion: Baseline IgE levels may be used to predict which patients will gain benefit from omalizumab therapy in CIU/CSU group. During omalizumab therapy the plasma D-dimer levels show a dramatic decrease in the group of patients who responded of CIU/CSU and BP.