title: Omalizumab in chronic urticaria: our experience and literature review.
abstract: BACKGROUND
  Chronic urticaria (CU) severely affects quality of life. If symptoms are not controlled by antihistamines, patients need immunomodulatory drugs. Recent studies show a tremendous effect of omalizumab, a monoclonal antibody against human IgE in refractory CU.
  
  
  METHODS
  We report on the use of omalizumab in four patients with CU. By reviewing medical files, we estimated the proportion of CU patients that are candidates for such treatment. We reviewed the literature to compare the dosing schedules and outcome measures used in different studies.
  
  
  RESULTS
  Up to 14% of CU patients referred to a tertiary center are candidates for omalizumab. Four of our CU were patients treated with doses of 150 mg/month or less, and all responded with nearly complete remission of symptoms. In the literature, 90% of patients respond to treatment, the response being obvious in days. Half of patients were able to stop all other medications, including antihistamines. More than half of patients responded well to doses of 150 mg of omalizumab every 4 to 8 weeks. In the majority of patients, the disease relapsed after discontinuation of omalizumab.
  
  
  CONCLUSIONS
  Omalizumab should be offered to patients with refractory CU. The duration of treatment is not known.
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia. Corresponding author: mitja.kosnik@klinika-golnik.si.
authors.forename: Mitja
authors.initials: M
authors.lastname: Košnik
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Peter
authors.initials: P
authors.lastname: Kopač
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Renato
authors.initials: R
authors.lastname: Eržen
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Nissera
authors.initials: N
authors.lastname: Bajrović
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Katja
authors.initials: K
authors.lastname: Adamič
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Nika
authors.initials: N
authors.lastname: Lalek
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Peter
authors.initials: P
authors.lastname: Korošec
authors.affiliation: University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Zidarn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D011788:Quality of Life; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab