Sparse data are available regarding the utility of omalizumab for Chronic Urticaria (CU) in children. We aimed to assess the effect of omalizumab in a pediatric CU cohort.
This was a prospective case series of 9 children between the ages of 7 and 18 years followed for CU (i.e. hives for at least 6 weeks), at the Montreal Children’s Hospital. All patients were treated with omalizumab (Xolair™, 150-450mg). Data were collected at study entry on demographics, co-morbidities and management through a standardized questionnaire. Prior to treatment, patients completed a weekly aggregated Urticaria activity score (UAS7). For consenting patients, we conducted analysis of CD63 expression at study entry to assess basophil activation.
There were 4 (44.4%) males and 5 (55.6%) females, ranging in age from 7 to 18 years (mean age 13.6 years). Mean UAS7 was 18.6 (range: 0-40) and mean CD63 was 15.7% (range: 0.48-62.2%; n=7). Of the 9 patients, 3 received 150mg of Xolair™ and 6 received 300mg or more. Following treatment, 55.6% of patients reported complete disappearance of wheals, 22.2% reported fewer wheals, 11.1% reported no new wheals, and 11.1% found no effect. The time for effect was 1 to 3 days (33.3%), 4 to 7 days (11.1%), 2 weeks (11.1%) or 1 to 5 months (33.3 %). Of the 3 patients who stopped treatment, 1 reported a recurrence of symptoms within 1 month.
Omalizumab can contribute to better management of CU in children. Large scale studies are required to assess factors associated with treatment success.