Lirentelimab shows promise in treatment-resistant chronic urticaria

In patients who suffer from antihistamine-resistant chronic urticaria (CU), lirentelimab seems to be effective at controlling the disease and reducing disease activity, reports a recent study.

Researchers conducted a phase IIa study in 47 patients with CU refractory to up to 4-fold H1-antihistamine doses. Lirentelimab was given at 6-monthly intravenous doses (0.3, 1, and up to 3 mg/kg). Scores in the Urticaria Control Test at week 22 was set as the primary efficacy endpoint. Disease activity was also evaluated.

Of the 47 patients, 21 had chronic inducible urticaria (CIndU), of whom 11 were diagnosed with cholinergic urticaria (CholU) and 10 with symptomatic dermographism (SDerm). In comparison, 26 had chronic spontaneous urticaria (CSU), 14 of which were naïve to omalizumab, while 12 were refractory.

Urticaria Control Test scores increased across all CU subgroups relative to baseline. The mean changes were 11.1, 4.8, 6.5, and 3.4 points in the omalizumab-naïve and -refractory CSU groups, CholU, and SDerm groups, respectively.

Meanwhile, corresponding complete response rates, defined as an Urticaria Control Test score ≥12, were 92 percent, 36 percent, 82 percent, and 40 percent.

Disease activity likewise decreased substantially in both CSU subtypes, with treatment response rates of 77 percent and 45 percent of the omalizumab-naïve and -refractory subgroups. Lirentelimab also completely resolved itches and hives in 50 percent and 40 percent of SDerm patients, respectively.

“Adequately powered double-blind, placebo-controlled randomized studies in populations with CSU and CIndU are warranted to further characterize lirentelimab for treatment of CU,” the researchers said.