An Italian study investigated coagulation cascade activation in the context of chronic spontaneous urticaria [CSU]. The identified D-Dimer values were correlated to disease activity.
The exact pathogenesis of mast cell activation in CSU is still not entirely clear . Recent findings imply a role not only of the immune system dysregulation and activation of the inflammatory cascade, but also of the coagulation pathway in CSU pathogenesis. Dr Antonio Cristaudo (San Gallicano Dermatological Institute, Italy) and his colleagues looked into the involvement of coagulation factors . They were particularly interested in a possible capacity of D-dimers and/or prothrombin fragments F1+2 to anticipate treatment response to omalizumab in CSU patients. 40 patients were included into the trial. Prerequisite for enrolment was the presence of wheals with or without presence of angioedema for ≥ 6 weeks. Laboratory testing was performed for activation markers of complement C3 and C4, prothrombin and partial thromboplastin time together with markers of coagulation activation and D-dimers in the plasma.
The assessment revealed a direct correlation of the amount of D-dimer with severity of CSU. Of ther participants, 20% were being treated with omalizumab due to their inadequate disease control with antihistamines. In a preliminary analysis, the investigators found a reduction in D-dimer plasma values in those who had good response to omalizumab therapy. They estimate that D-dimers may qualify as predictor of clinical response to omalizumab treatment and as a biomarker for CSU severity.
- Puxeddu I, et al. J Asthma Allergy. 2019;12:285-295.
- Cristaudo A, et al. P1978, EADV 2019, 9-13 Oct, Madrid, Spain.
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Table of Contents: EADV 2019
Letter from the Editor
IL-17A blocker effective in paediatric psoriasis patients
Rituximab beats mycophenolate mofetil in pemphigus vulgaris
Novel JAK1/2 inhibitor shows remarkable efficacy in alopecia areata
Acne highly influenced by climate, pollutants, and unhealthy diet
JAK inhibition plus TCS lead to high clearance rates in AD
No cancer risk with long-term use of tacrolimus, a topical calcineurin inhibitor, in children with AD
Green light for a second JAK inhibitor in AD
Topical ruxolitinib effective in vitiligo
Small molecules: interesting novel treatment options in AD
IL-1⍺ blockade: a new treatment option in AD
IL-4/IL-13 blockade leads to rapid itch reduction in adolescents
How to manage conjunctivitis in AD patients treated with a biologic
Biologics: increasingly used in paediatric dermatology
Spotlight on Psoriasis
IL-17 blocker: effective and safe in patients with comorbidities
ESPRIT registry: sharp decline in mortality in patients treated with a TNF blocker
Relationship psoriasis and NAFLD: new data on the hepato-dermal axis
Novel selective IL-23 blocker equally effective in patients with metabolic syndrome
Selective IL-23 blocker crushes fumaric acids in all assessed efficacy endpoints
No hint of teratogenicity through ixekizumab
New Insights in Photoprotection
Systemic photoprotection: a valuable addition to topical sun protection
The underestimated effect of visible light
Comorbidities more common in chronic urticaria, psoriasis, and AD
D-Dimer as future biomarker in CSU management?
Ligelizumab for CSU: symptom control and high response rates in re-treatment
Rosacea – From New Spectrum to New Therapy
New guidance on rosacea therapy according to phenotype
Best of the Posters
Above-the-neck melanoma more prone to metastases
Reduced sleep quality in dermatoses influenced by itch and pain
Anxiety and depression are common in families of AD infants
Certolizumab pegol efficacious for head and neck psoriasis
Bimekizumab in psoriasis: Up-and-coming
A patient-related approach to freedom of disease
Small molecules, apremilast, and TYK2