Both Extrinsic and Intrinsic Atopy in Chronic Spontaneous Urticaria Patients Indicate a Favorable Response to Omalizumab Treatment
Bibliographic record
Abstract
Abstract: Background: Chronic spontaneous urticaria (CSU), a debilitating condition, is often treated with omalizumab for antihistamine-refractory cases. Atopy subtypes (extrinsic/intrinsic) may influence CSU clinical features and treatment responses, but remain understudied. Objective: To assess the clinical relevance of atopy subtypes in CSU and their link to omalizumab response. Methods: Retrospective analysis of 210 omalizumab-treated CSU patients assessed through allergen-specific immunoglobulin E (IgE), total IgE, personal/family history, and atopic signs. Groups: nonatopic, extrinsic, or intrinsic atopic. Treatment response, onset speed, and safety profiles were evaluated. Results: Atopy prevalence was 70% (extrinsic: 50.5%, intrinsic: 19.5%). Extrinsic atopic patients showed higher personal/family urticaria history and annular/semi-annular wheals. Nonatopic patients were older, with more red plaques/patches and higher IgG-anti-thyroid microsome (IgG-anti-TM) positivity. Atopy predicted a favorable omalizumab response. Omalizumab response rates were superior in extrinsic (97.2%) and intrinsic (95.1%) groups versus nonatopic (77.8%, P < 0.001). Nonatopic patients experienced faster symptom relief (28.6% ≤24 hours vs 9.7–20.5%, P = 0.012). Adverse events were more frequent in atopic subgroups (18.9–22.0% vs 4.8%, P = 0.020). Low total IgE (<40 IU/mL) correlated with reduced group responses. Conclusion: Both extrinsic and intrinsic atopy predict better omalizumab responses in CSU. Intrinsic atopic CSU, often neglected, requires further study for personalized approaches. Comprehensive atopy evaluation improves therapeutic stratification in CSU.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".