Bullous pemphigoid
OMZ use in BP was analyzed in a systematic review which included 13 case
series/reports and analyzed 56 patients. Complete response was achieved
in 55.4% of patients with an overall response rate of 87.5%. While
baseline eosinophilia was marginally associated with complete remission,
no association with baseline IgE could be shown168.
French BP Management Guidelines recommend the use of omalizumab in a
subset of patients with predictors for OMZ efficacy, i.e.urticarial lesions, significant blood eosinophilia, high serum IgE
levels, even though the relapse rate reported was up to
80%169. Of note, a clinical trial (NCT01688882) to
evaluate the efficacy and safety of OMZ in patients with active BP
despite oral steroid treatment was terminated because the predefined
criteria of efficacy were not reached. Currently, only one ongoing trial
indirectly targeting IgE-associated mechanisms (dupilumab) is conducted
in this indication (NCT05649579).