Anti-KIT Drug Shows Strong Efficacy in Chronic Spontaneous Urticaria

New data presented at the American Academy of Allergy, Asthma & Immunology annual meeting highlighted promising results for emerging therapies in chronic spontaneous urticaria (CSU), including high response rates and sustained disease control.

In this exclusive MedPage Today video, Nicole Chase, MD, of St. Paul Allergy & Asthma in Minnesota, discusses findings on barzolvolimab — an investigational humanized monoclonal antibody — in CSU, including efficacy, durability, and considerations for clinical use.

Following is a transcript of her remarks:

I think the biggest story still is barzolvolimab from Celldex. So this is the anti-KIT, mast-cell-depletion approach to CSU. And it looks like not only did barzo [barzolvolimab] just kill it really in the sense of UAS7 [weekly Urticaria Activity Score] all the way to zero for patients with CSU that was sustained for quite some time, and then actually redosing seems to work very well. They also now have data on this in chronic inducible urticaria or CIndU. And this is probably the first thing we’ve actually seen that has good CIndU data.

They’re hitting rates that are almost double that of omalizumab [Xolair], of dupilumab [Dupixent], as far as UAS7 almost to zero. I think it was like 0.4 was their average UAS7. And so I think that that was really what looked most exciting to me was the barzo story.

I think that they have some issues to address in terms of people that take barzo have changes in their hair color. And I think that this as a side effect of this medication is definitely something that we’re going to have to talk with patients about and see if they’re OK with it.

There was some data on cytopenias, nothing that looked terribly concerning to me, but at the same time, I think that it’s really the efficacy that they’re showing. I mean, upwards of 70% is just incredible. And then they also had data on DLQI [Dermatology Life Quality Index], which as allergists, we don’t really know DLQI, but at the same time, I think it’s a good scoring system for us to start to learn about because realistically it just looks like quality of life metrics in general, and their data looked really, really impressive.

I think that the Celldex people are definitely wondering, is this disease modifying? Is this actually just a treatment-related effect? I’m not sure yet. Part of me thinks it’s just that mast cells take a long time to get themselves back together, and so once you deplete them, it’s just going to take you several months. But they do have really good extension data showing that when you actually do relapse, you do retreat really well. So you actually respond really well to your retreatment with the drug, which I think is really important given that this is a medication that we want to be able to reutilize and we don’t really necessarily want to have to give it on any kind of schedule if patients don’t need it. But when they do need it, we want to be able to pull it out off the shelf again and give it without developing tolerance to it or anti-drug stuff like that.

So I think that Celldex looks really… they should be very excited with their data. The stuff that I saw at the meeting was very impressive.

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