Remission of chronic urticaria in patients treated with omalizumab

Abstract

Chronic spontaneous urticaria (CSU) is characterized by the occurrence of itchy wheals, angioedema, or both, without identifiable triggers, persisting for at least 6 weeks (1). It usually occurs in the form of relapses and remissions. The more severe the disease, the lower the likelihood of its remission (2-4). CSU may significantly impair the quality of life (5). Disease activity is measured with the urticaria activity score (UAS). Daily UAS values can range from 0 to 6 points, depending on the number of wheals (0 to 3) and the intensity of pruritus (0 to 3) (5, 6). Treatment is aimed at complete control of the signs and symptoms (1). The primary medications are second-generation H1-antihistamines (sgAH), which are taken regularly in a dose of one to four tablets per day. Omalizumab is commonly used to treat patients with sgAH-resistant CSU. It is an anti-IgE humanized monoclonal antibody that lowers the concentration of free IgE and downregulates high-affinity receptors for IgE (FcεRI) on mast cells and basophils, preventing their degranulation (7). Omalizumab treatment is symptomatic and has no effect on the natural course of CSU (8). We aimed to observe the probability of disease remission in patients with sgAH-resistant CSU and its duration after discontinuation of omalizumab.