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Omalizumab updosing for better disease control in chronic spontaneous urticaria patients

International Archives of Allergy and Immunology Aug 27, 2018

Kocatürk E, et al. - Considering the chronic spontaneous urticaria (CSU) patients who do not benefit from the recommended dose of omalizumab (300 mg every 4 weeks), researchers presented the experiences on the use of higher doses of omalizumab and proposed a protocol for updosing. They performed a retrospective analysis of patients treated with omalizumab for CSU from 2 urticaria centers in Istanbul and Barcelona. A stepwise updosing regimen was preferred (450 mg first, then increasing to 600 mg) in Barcelona, while direct updosing to 600 mg was chosen in Istanbul. As per results, a stepwise approach starting from 450 mg and then updosing to 600 mg is recommended for CSU patients who do not respond or partially respond to 300 mg of omalizumab after 3–6 months of treatment. When responders to 150–300 mg (n = 123) were compared with responders to 450–600 mg, it was noted that patients receiving updosed omalizumab had higher BMI and lower pre-omalizumab Urticaria Control Test.
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