Asthma medication eases pain, boosts life quality for hEDS patient
Omalizumab approved in US for asthma, hives, sinus infections
A 33-year-old woman with hypermobile Ehlers-Danlos syndrome (hEDS) experienced less systemic (body-wide) pain and inflammation, as well as greater overall functioning after starting treatment with omalizumab, a medication for asthma and allergies, according to a recent report.
Omalizumab is an injectable therapy that blocks the interaction of immunoglobulin E (a type of antibody produced by the body) with immune mast cells and a type of white blood cell called basophils. This is intended to prevent an immune-mediated reaction. The antibody therapy, marketed as Xolair, is currently approved by the U.S. Food and Drug Administration for forms of urticaria (hives), chronic sinus infections, and asthma.
“While omalizumab has been beneficial in decreasing systemic inflammation and pain, this most importantly has led to an increase in the patient’s functional mobility and independence,” researchers wrote.
The case was described in an article, “Systemic pain relief after omalizumab injection in patient with hypermobile Ehlers–Danlos syndrome: A case report,” published in the journal Clinical Case Reports.
Ehlers-Danlos syndrome (EDS) includes a group of genetic disorders affecting the body’s connective tissues, which provide structure to joints, skin, blood vessels, and other tissues and organs.
Hypermobile EDS is most common disease type
hEDS, the most common EDS type, is characterized by soft and fragile skin, and joint hypermobility, where joints can move in a much wider range of motion than normal. Therefore, people with hEDS experience frequent joint dislocations and chronic, debilitating pain in the muscles, bones, and joints.
However, “treating pain in patients with hypermobile [hEDS] is complex and must be addressed in a multidisciplinary fashion,” the researchers wrote.
In the report, a team at Penn State College of Medicine described the case of a woman with hEDS who had severe pain that resulted in significant functional impairment, poor quality of life, and social isolation. She had a previous medical history that included depression, chronic urticaria, and fibromyalgia.
To improve her independence, functionality, and quality of life, the patient was being treated for hEDS and coexisting disorders, including mast cell activation syndrome, which causes repeated severe allergy symptoms, and postural orthostatic tachycardia syndrome, which results in symptoms such as a fast heart rate and dizziness when moving from lying down to standing up.
Despite the use of several types of treatment, her chronic symptoms remained uncontrolled. She was unable to use potentially beneficial medications because of her significant history with allergies.
Moreover, the patient was unable to tolerate an anti-inflammatory diet due to gastroparesis — low stomach motility that leads to difficult digestion — and failed physical and cognitive behavior therapies as a result of her pain and due to financial concerns.
Omalizumab led to significant easing of inflammation, swelling
In January 2023, she started receiving omalizumab injections to treat her allergy symptoms. After five treatments, the patient reported significant easing of systemic inflammation and swelling. Subsequently, she reported less pain and significantly better overall functioning, including the ability to perform activities of daily living, and more involvement in the community, and with her family and friends.
Before starting on omalizumab, she rated her pain 10 out of 10 using a visual analog scale. Treatment led to a consistent reduction (benefit) to scores of 6-7. A 3-point reduction in the score is clinically relevant, the scientists noted, as it is perceived by patients as sufficient pain control.
“Further research can evaluate the relationship between omalizumab and pain in hEDS,” the researchers wrote. “If found beneficial … we hope for earlier integration of omalizumab into the multi-dimensional treatment regimen hEDS patients require to improve pain control, ability to perform [activities of daily living] and functionality and social engagement, and most importantly, quality of life.”