Is There a Difference in Omalizumab Treatment Response in Patients With Chronic Autoimmune Urticaria vs Chronic Spontaneous Urticaria?
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Kiranjit K. Khalsa, MD, Gargi Patel, Natalia Testo, MD, Muhammad A. Pasha, MD FAAAAI

To investigate the correlation between utility of chronic urticaria index (CUI), concurrent use of systemic steroids, antihistamines, and persistence of symptoms in patients with refractory chronic idiopathic urticaria (CIU), treated with omalizumab.


Retrospective chart review of 39 patients with either Chronic Autoimmune Urticaria (CAU) or Chronic Spontaneous Urticaria (CSU) treated with omalizumab in a university based practice. Histories were evaluated for resolution of symptoms, prednisone use, CUI, and dose related side effects to either 150 mg or 300 mg of omalizumab.


Of the 39 patients, thirty (76%) had CUI drawn, eleven (36%) of which were positive. Thirty- two patients (82%)were on 300 mg while only seven (17%) were on 150 mg of omalizumab. Patients who experienced hives prior to their injection on week four were switched to a three week regimen with improvement in symptoms. Two patients on 300 mg experienced headaches and dizziness. One had their dose decreased to 150 mg with resolution of symptoms, the other discontinued the treatment. Twenty-four of the thirty-nine patients (61%) on prednisone prior to starting omalizumab no longer required prednisone.


When comparing CAU and CSU patients on Omalizumab, we found no difference in the symptom resolution or corticosteroid use. However, omalizumab was an effective steroid sparing agent overall. Rather than discontinuing omalizumab all together due to certain side effects, dose reduction may help to resolve adverse effects while still maintaining control. In addition, an increase in dose frequency may help to maintain symptom control.