According to the study, researchers established a new treatment for CSU patients, where the ef?cacy and safety of the anti-IgE monoclonal antibody omalizumab in chronic spontaneous urticaria (CSU) not responding to antihistamine treatment. The main aim of our study was to describe the response patterns of patients with refractory CSU treated with omalizumab in a real-world clinical setting. The study published in the International Journal of Dermatology.

The researchers found that mean disease duration before omalizumab administration was 21.8 months. All patients responded favorably to omalizumab after one to five doses, with 85% of patients having a complete response. The remaining three patients had well-controlled disease after omalizumab treatment.

In 30 percent of patients, the best response to omalizumab was achieved after interval administration of a nine-day course of methylprednisolone. Background Previous clinical trials have demonstrated the ef?cacy and safety of the anti- IgE monoclonal antibody omalizumab in chronic spontaneous urticaria (CSU) not responding to antihistamine treatment.

A retrospective analysis of medical records of 20 patients with refractory CSU was performed. Demographic, clinical, and laboratory features were retrieved and analyzed in correlation with treatment data. Results Mean age of our patient population was 54.5 years, while the majority were females (15/20 cases, 75%). Mean disease duration prior to omalizumab administration was 21.8 months.

All patients had a history of chronic urticaria, refractory to high anti-histamine and corticosteroid treatment, and responded favorably to omalizumab after administration of 1–5 doses of omalizumab; complete response was observed in 17/20 patients (85%) and well-controlled disease in the remaining 3/20 patients (15%).  In a subset of cases (6/20, 30%), best response to omalizumab was achieved after interval administration of a 9-day course of methylprednisolone (total dose of 188 mg).

Late response to omalizumab (after three-month treatment) was signi?cantly correlated (P = 0.026) with shorter disease duration before initiation of omalizumab. In the present series, omalizumab, either alone or in combination with a short- term course of corticosteroids, was highly effective in resolution of refractory CSU. Furthermore, disease duration prior to omalizumab had a signi?cant effect on timing of response.

Mean age of our patient population was 54.5 years, while the majority were females (15/20 cases, 75%). Mean disease duration prior to omalizumab administrationwas 21.8 months. All patients had a history of chronic urticaria, refractory to high antihistamine and corticosteroid treatment, and responded favorably to omalizumab afteradministration of 1–5 doses of omalizumab; complete response was observed in 17/20patients (85%) and well-controlled disease in the remaining 3/20 patients (15%).

In asubset of cases (6/20, 30%), best response to omalizumab was achieved after intervaladministration of a 9-day course of methylprednisolone (total dose of 188 mg).

In future studies, omalizumab either alone or in combination with a short-term course of corticosteroids, was highly effective in resolution of refractory CSU. Furthermore, disease duration prior to omalizumab had a signi?cant effect on timing of response.