Amaç: Kronik Spontan Ürtiker (KSÜ) hastalarında Omalizumab'a altı aylık klinik yanıtı ve tedavi kesimi sonrası uzun vadeli nüks riskini öngörmede bazal Sistemik İmmün-İnflamasyon İndeksi (SIRI) ve Agregat Sistemik İnflamasyon İndeksi'nin (AISI) prediktif performansını değerlendirmektir. Gereç ve Yöntemler: Bu tek merkezli, retrospektif çalışmaya 312 KSÜ hastası dahil edildi; tedavisi kesilen 217 hasta nüks açısından takip edildi. Birincil sonlanım 6. ayda iyi tedavi yanıtı (Ürtiker Kontrol Testi [ÜKT] skoru ≥12), ikincil sonlanım tedavi kesimi sonrası nüks olarak tanımlandı. Performans ROC analizi ve lojistik regresyon ile değerlendirildi. Bulgular: Yanıt vermeyen grubun (n=38) bazal SIRI (Medyan 1.47 vs. 1.06; p<0.001) ve AISI (Medyan 452.98 vs. 306.06; p<0.001) değerleri, yanıt veren gruba (n=274) göre anlamlı olarak daha yüksekti. Yanıt vermemeyi öngörmede hem AISI (AUC=0.744) hem de SIRI (AUC=0.727) güçlü performans gösterdi. Nüks alt grubunda (n=217), nüks gelişenlerin (n=122) bazal SIRI (p=0.012) ve AISI (p=0.024) değerleri remisyonda kalanlara (n=95) göre anlamlı düzeyde yüksekti. Sonuç: Bazal SIRI ve AISI değerleri, KSÜ hastalarında Omalizumab'a yetersiz yanıtı ve nüks riskini öngörmede değerli, pratik ve uygun maliyetli biyobelirteçlerdir. Bu indeksler, tedavi kararlarına rehberlik etmede ve hasta yönetimini optimize etmede klinisyenlere yardımcı olabilir.
Anahtar Kelimeler: Ürtiker, Omalizumab, Biyobelirteçler, Tedavi Sonucu, Nüks
Cite this Article As :
Gerek ME, Colkesen F, Sagun F, Kolak S, Onalan T, Akkus FA, Sadi Aykan F, Kahraman S, Arslan S. Elevated Baseline Systemic Inflammation Indices Predict
Poor Response and Higher Relapse Risk in Chronic Spontaneous Urticaria Patients on Omalizumab. Selcuk Med J 2026;42(2): 135-143
1. Maurer M, Abuzakouk M, Bérard F, et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy. 2017;72(12):2005-16. doi:10.1111/all.13209
2. Curto-Barredo L, Silvestre JF, Giménez-Arnau AM. Update on the treatment of chronic urticaria. Actas Dermosifiliogr. 2014;105(5):469-82. doi:10.1016/j.ad.2012.12.019
3. Folci M, Heffler E, Canonica GW, et al. Cutting edge: biomarkers for chronic spontaneous urticaria. J Immunol Res. 2018;2018:5615109. doi:10.1155/2018/5615109
4. Beck LA, Bernstein JA, Maurer M. A review of international recommendations for the diagnosis and management of chronic urticaria. Acta Derm Venereol. 2017;97(2):149-58. doi:10.2340/00015555-2496
5. Liu X, Li J, Sun L, et al. The association between neutrophil-to-lymphocyte ratio and disease activity in rheumatoid arthritis. Inflammopharmacology. 2023;31(5):2237-44. doi:10.1007/s10787-023-01273-2
6. Mercan R, Bitik B, Tufan A, et al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016;30(5):597-601. doi:10.1002/jcla.21908
7. Kucharczyk A, Marczyk K, Kucharczyk B, et al. Predicting relapse in chronic spontaneous urticaria: A retrospective cohort study evaluating omalizumab withdrawal regimens. Allergy. 2024;79(9):2554-7. doi:10.1111/all.16194
8. Foti C, Romita P, Ambrogio F, et al. Analysis of clinical factors as possible predictors of response to omalizumab and relapse after treatment discontinuation in chronic spontaneous urticaria. Dermatol Ther. 2022;35(2):e15248. doi:10.1111/dth.15248
9. Soegiharto R, Alizadeh Aghdam M, Sørensen JA, et al. Multinational drug survival study of omalizumab in patients with chronic urticaria and potential predictors for discontinuation. JAMA Dermatol. 2024;160(9):927-35. doi:10.1001/jamadermatol.2024.2056
10. Marzano AV, Genovese G, Casazza G, et al. Predictors of response to omalizumab and relapse in chronic spontaneous urticaria: a study of 470 patients. J Eur Acad Dermatol Venereol. 2019;33(5):918-24. doi:10.1111/jdv.15350
11. Zhang DG, Sørensen JA, Ghazanfar MN, et al. EXtending omalizumab treatment Intervals in patients with chronic spontaneous urticaria (EXOTIC): protocol of a multicentre, randomised, open-label, non-inferiority trial. BMJ Open. 2025;15(1):e084987. doi:10.1136/bmjopen-2024-084987
12. Kuna M, Štefanović M, Davidović L, et al. Chronic urticaria biomarkers IL-6, ESR and CRP in correlation with disease severity and patient quality of life—a pilot study. Biomedicines. 2023;11(8):2232. doi:10.3390/biomedicines11082232
13. Kasperska-Zajac A, Grzanka A, Damasiewicz-Bodzek A. IL-6 transsignaling in patients with chronic spontaneous urticaria. PLoS One. 2015;10(12):e0145751. doi:10.1371/journal.pone.0145751
14. Grzanka R, Damasiewicz-Bodzek A, Kasperska-Zajac A. Interplay between acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2018;14:27. doi:10.1186/s13223-018-0255-8
15. Karabay EA, Çerman A, Altunay I. Serum c-reactive protein, neutrophil-lymphocyte ratio and uric acid levels in chronic spontaneous urticaria. Turkiye Klinikleri J Dermatol. 2016;26(3):125-31. doi:10.5336/DERMATO.2016-52709
16. Qiu X, Ran Q, Pan J, et al. Neutrophil/lymphocyte ratio as a biomarker of response to H1-antihistamine therapy in patients with chronic spontaneous urticaria. Indian J Dermatol. 2024;69(5):367-70. doi:10.4103/ijd.ijd_558_22
17. Coşansu NC. Evaluation of new inflammatory parameters in patients with chronic spontaneous urticaria: a new predictor of refractoriness to antihistamine treatment. Namik Kemal Med J. 2020;8(3):404-11. doi:10.37696/nkmj.731617
18. Bakay OSK, Kacar N, Gul B, et al. What can be learned from real-world data about chronic spontaneous urticaria? Allergy Asthma Proc. 2024;45(4):255-61. doi:10.2500/aap.2024.45.240041
19. Atik Ö, Tepetam FM, Özden Ş, et al. Eosinophilic cationic protein and D-Dimer are potential biomarkers to predict response to antihistamines but not to omalizumab in chronic spontaneous urticaria. Libyan J Med. 2024;19(1):2420483. doi:10.1080/19932820.2024.2420483
20. Miyatani Y, Kobayashi T. Evidence-based approach to the discontinuation of immunomodulators or biologics in inflammatory bowel disease. Digestion. 2022;104(1):66-73. doi:10.1159/000527776
21. Imbert A, Gavlovsky P-J, Judor J-P, et al. T cell immuno-phenotyping : a source of predictive biomarkers for autoimmune hepatitis relapse. Sci Rep. 2024;14(1):24448. doi:10.1038/s41598-024-75624-6
22. Asero R, Ferrer M, Kocaturk E, et al. Chronic spontaneous urticaria: The role and relevance of autoreactivity, autoimmunity, and autoallergy. J Allergy Clin Immunol Pract. 2023;11(8):2302-8. doi:10.1016/j.jaip.2023.02.022
23. Asero R, Tedeschi A. Chronic spontaneous urticaria: from the hunt for causes and pathogenesis to the identification of different endotypes. Eur Ann Allergy Clin Immunol. 2023;55(6):253-60. doi:10.23822/EurAnnACI.1764-1489.307
24. Sella JA, Ferriani MPL, Melo JML, et al. Type I and type IIb autoimmune chronic spontaneous urticaria: Using common clinical tools for endotyping patients with CSU. J Allergy Clin Immunol Glob. 2023;2(4):100159. doi:10.1016/j.jacig.2023.100159
25. Wong D, Waserman S, Sussman GL. Endotypes of chronic spontaneous urticaria and angioedema. J Allergy Clin Immunol. 2025;156(1):17-23. doi:10.1016/j.jaci.2025.04.004
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Keywords
Ürtiker, Omalizumab, Biyobelirteçler, Tedavi Sonucu, Nüks