Chronic Spontaneous Urticaria Learning Zone
Transcript: Therapies for CSU management
Marcus Maurer, MD, and Petra Staubach-Renz, MD
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speakers and is not adjusted by Medthority.
- What are my thoughts on the new treatments for urticaria that are in clinical trials? Oh my goodness. Do you have an hour or two that you want to stay? I love the clinical trials that we're doing and I love- - Maybe next session, Marcus. - Maybe next session. - Topic for the next session we can talk about in one sentence. - Yeah, absolutely. And thank you all for contributing as study centres to these clinical trials. I think this is for many patients with urticaria, something entirely novel that there are clinical trials that they can participate in. And finally, I mean, finally we have the clinical trials with so many interesting new treatment approaches. Deleting mast cells, silencing mast cells, better anti-IgE anti-TSLP, anticomplement, anti-H4 receptor antagonists, mamma mia! I mean, who would've thought 10 years ago that we would ever have more than one study to offer to patients to participate in. It is fantastic and I think this will make many of our patients over the next years- - Yeah. - So much better. - And like an Omalizumab, in other diseases as well. And here we have an interdisciplinary approach as well in some treatments and- - Oh, yeah. - They are launched very, very soon. So it's really interesting at the moment.
- Yes. - And I'm happy that those, some of those studies, sorry to say this, that they are available for children as well and this is important. - Yes. - Even from six years on, so we are happy that we can run those studies in children. - Yeah. No, absolutely. And I see Moisa has joined. Hi, Moisa. Thank you for contributing. Erica wants to know about combination of two biologics. We have used various combinations for two different diseases in the same patient, but also two biologics for the same disease. So, so far we have not run into any problems. And one question here that goes a little bit along these lines, will we be moving to targeted and personalised treatment?
Absolutely. We are already thinking about endotype specific treatment, you know. And if you break this down and you learn more about the pathomechanisms and get targeted treatments for the different pathomechanisms that make patients have urticaria, well, you end up with personalised medicine, personalised treatment. We're not there yet, but I do predict that we will, in the future, pick one treatment for one group of patients and another treatment for another group of patients. - But we are going in the right direction because think about the guidelines. A personalised medicine is also if you can say, okay, we treat every three weeks or we need a higher a dosage and we want the companies that we can decide for each patient the dosage. And this is important that we have studies to show this. - Yes. - And this is personalised medicine as well.
- Absolutely. Absolutely. Do we go higher than 300 mg? Petra? Yes. - Yes, - Yes, of course. Look, we- - And we shorten the duration as well. - Which comes down to the same thing. No, sometimes we do both. The best thing you can do for a patient who does not respond to standard dose to omalizumab is give it more and give it more often. And this is not very different from what we've been saying about antihistamines for the last 20 years, no? We need the higher dose or we should use the higher dose when the standard dose doesn't work.
- Yeah. And it works. - That is because- - It works if we do it. - It works. Oh, yeah, yeah. It works. And it is safe. And we could do it for a long time and we should do it for a long time in the absence of something better. - Yeah. - No? I will not be saying this in 10 years when we will have a choice of different ones that may even at standard dose be better than omalizumab. But right now this is the best thing we can do for patients and that's what we should do. And that's exactly also what the guideline says.
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