The Efficacy of Omalizumab in Cutaneous Mastocytosis: A Case Series

Abstract

Background

Mastocytosis describes a heterogeneous group of disorders arising from a clonal proliferation of mast cells. Given the lack of curative treatments for the cutaneous form, there is a significant need for superior therapies. Omalizumab is a recombinant DNA‐derived humanized IgG monoclonal antibody that selectively binds to human immunoglobulin E (IgE). It represents a potential treatment for the treatment of cutaneous mastocytosis, which currently has no standard treatment.

Methods

Two patients were treated with subcutaneous omalizumab 300 mg every four weeks.

Discussion

Patient one experienced 50% reduction in cutaneous infiltration and moderate improvement in pruritus. Patient two underwent 90% complete clearance of cutaneous lesions and reported full resolution of pruritus. The median duration of treatment was 24 weeks and time to response was eight weeks. No significant changes in tryptase levels were observed. Both patients experienced injection site reactions.

Conclusion

We provide evidence from two cases supporting the efficacy of IgE‐mediated therapy in the treatment of cutaneous mastocytosis. Even at a higher‐than‐standard dose (300mg versus 150mg), the drug was well‐tolerated. As we await the results of pivotal clinical trials, omalizumab appears to be a promising treatment option in patients with cutaneous mastocytosis unresponsive to traditional therapies.

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