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Update on Omalizumab for Urticaria: What’s New in the Literature from Mechanisms to Clinic

  • Allergic Skin Diseases (L Fonacier, Section Editor)
  • Published:
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Abstract

Purpose of Review

Since omalizumab has been approved for urticaria, numerous randomized and real-life observational trials have been published. We reviewed the period January 2017–February 2018.

Recent Findings

Omalizumab is effective for the control of urticaria recalcitrant to antihistamines in different populations globally. The ratio of total serum IgE 4-week/baseline ≥2 can predict response with a high likelihood. In observational real-life trials, doses have been adjusted on an individual basis: in some populations, up to two-thirds of the patients can be controlled with 150 mg/month; however, others are still not controlled with 300 mg/month. In these, 150 mg bimonthly could be tried, before up-dosing to 450 mg/month. On the long run (up to 3 years) omalizumab kept its efficacy. In many patients, dosing intervals could be augmented (6–8 weeks, some even more). After a 12-month treatment, about 20% showed long-term remission without relapse.

Summary

Some biomarkers are being detected. Adjusting omalizumab doses in urticaria patients could enhance efficacy (shortening dosing interval and/or augmenting dose) and save costs (after 12 months: extending dosing interval and/or reducing dose).

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Authors and Affiliations

  1. Research Unit, Medica Sur Hospital and Clinical Foundation, Torre 2, cons.602, Puente de Piedra 150, Col. Toriello Guerra, Del. Tlalpan, 14050, México, D.F, Mexico

    Désirée E. S. Larenas-Linnemann

  2. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Claudio A. S. Parisi

  3. Hospital Italiano, Buenos Aires, Argentina

    Carla Ritchie

  4. Grupo de Alergología Clínica y Expermiental, IPS Universitaria, Universidad de Antioquia, Medellín, Colombia

    Ricardo Cardona-Villa & Jorge Mario Sánchez Caraballo

  5. Espiritu Santo University (UEES), Samborondon, Ecuador

    Ivan Cherrez-Ojeda

  6. Respiralab Research Group, Guayaquil, Ecuador

    Annia Cherrez

  7. Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany

    Annia Cherrez

  8. Federal University of São Paulo, Hospital Sírio-Libanês, São Paulo, Brazil

    Luis Felipe Ensina

  9. Fundación Santa Fe de Bogotá – Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia

    Elizabeth Garcia

  10. Centro Médico Vitae, Buenos Aires, Argentina

    Iris V. Medina

  11. Private Practice, Mexico City, Mexico

    Mónica Rodríguez-González

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  1. Désirée E. S. Larenas-Linnemann
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Correspondence to Désirée E. S. Larenas-Linnemann.

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Conflict of Interest

Dr. Larenas-Linnemann reports personal fees from GSK, Astrazeneca, MEDA, Boehringer Ingelheim, Novartis, Grunenthal, UCB, Amstrong, Siegfried, DBV Technologies, MSD, Pfizer, grants from Sanofi, Astrazeneca, Novartis, UCB, GSK, TEVA, Chiesi, Boehringer Ingelheim, outside the submitted work. The other authors declare no conflicts of interest relevant to this manuscript.

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Larenas-Linnemann, D.E.S., Parisi, C.A.S., Ritchie, C. et al. Update on Omalizumab for Urticaria: What’s New in the Literature from Mechanisms to Clinic. Curr Allergy Asthma Rep 18, 33 (2018). https://doi.org/10.1007/s11882-018-0787-5

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