Efficacy of Omalizumab in Treatment-Resistant Chronic Spontaneous Urticaria

Abstract

Objective: Chronic spontaneous urticaria is a disorder characterized by spontaneous development of pruritic erythematous plaques, angioedema or both. Omalizumab is a recombinant monoclonal antibody that selectively binds to IgE and inhibits its binding to FceRI receptors on mast cells and basophils. We sought to retrospectively assess the efficacy of Omalizumab, the adverse effects due to treatment, and the disease-free duration after treatment in treatment-resistant chronic spontaneous urticaria cases. Materials and Methods: The treatment responses of 24 chronic spontaneous urticaria cases treated with Omalizumab at our clinic were retrospectively evaluated. Results: The mean age of the patients was 44 years and the mean duration of disease was 7.2 years. The most common concomitant systemic disease was thyroid disease (29%). The duration of treatment ranged from 4 to 36 months, and total treatment doses from 5 to 28 doses. The treatment of 15 patients was still going on and the mean duration of treatment was 24.4 months. Disease control could not be achieved in three patients but the mean dose of disease control was 3.2 in the other patients. The treatment response was partial in 29% (n=7) and complete in 71% (n=17) of the patients. Side effects (erythema or urticarial plaque at the injection area, headache, dizziness, myalgia, arthralgia) were detected in eight patients. No recurrence was detected in five patients with a mean follow-up duration of 12 months after the treatment. The mean duration until recurrence was 7.7 months after the treatment in five patients who had recurrence. Conclusion: Omalizumab is a good treatment option, thanks to its efficacy and safety, in chronic spontaneous urticaria patients who do not respond to H1-antihistamines.