Photo Credit: Evgen_Prozhyrko
The following is a summary of “Off-label use of biologics in urticarial vasculitis: a European retrospective cohort study,” published in the January 2025 issue of Rheumatology by Maisonobe et al.
Urticarial vasculitis (UV) presents atypical urticarial lesions and leukocytoclastic vasculitis, sometimes involving other organs. Biologics have shown potential in refractory cases unresponsive to standard treatments.
Researchers conducted a retrospective study to evaluate the efficacy and safety of biologics in refractory UV.
They conducted a retrospective European multicenter study from 2008 to 2021, including patients with hypocomplementemic or normocomplementemic UV treated with at least one biologic, such as anti-CD20, anti-IgE, or IL-1 targeted therapy. Clinical and biological characteristics, along with the efficacy and safety of biologics, were analyzed.
The results showed 41 patients received 52 therapeutic sequences, including rituximab in 23, IL-1 targeted therapy in 16, and anti-IgE in 13 cases. UV was hypocomplementemic in 59% of cases. Biologics were used in the 5th line of treatment, with 75% combined with glucocorticoids. After a median follow-up of 25 months, cutaneous response was complete in 40%, partial in 37%, and inadequate in 23%. Glucocorticoid discontinuation occurred in 34% of patients. Serious adverse events, mainly infectious, were observed in 7 (17%) of patients.
Investigators concluded that biologics were effective and well-tolerated in treating refractory UV. These therapies provided significant improvements in patients unresponsive to conventional treatments.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keaf039/7976942
