Targeting IgE in Severe Atopic Dermatitis with a Combination of Immunoadsorption and Omalizumab
Alexander Zink, Anna Gensbaur, Michael Zirbs, Florian Seifert, Isabel Leon Suarez, Vagkan Mourantchanian, Stephan Weidinger, Martin Mempel, Johannes Ring, Markus Ollert
Patients with atopic dermatitis (AD) tend to have greatly elevated levels of serum immunoglobulin E (IgE). However, the role of IgE in the pathogenesis of AD is debated. This investigator-initiated open-label pilot study evaluates an anti-IgE-treatment approach by combining extracorporeal immunoadsorption and anti-IgE antibody omalizumab in 10 patients with severe, therapy-refractory AD. IgE levels decreased after immunoadsorption and decreased continuously in all patients during anti-IgE therapy. The reverse trend was observed during 6 months follow-up without treatment. In parallel with these observations, an improvement in AD was observed during the treatment period, with aggravation during follow-up. Further research is needed, based on the principle of reducing IgE levels in order to improve clinical symptoms, using a combination anti-IgE treatment approach, adjusted according to IgE levels.