title: Outcomes of using omalizumab for more than 1 year in refractory chronic urticaria.
abstract: BACKGROUND
  Because omalizumab was only recently approved for refractory chronic urticaria (CU), there are few studies that have evaluated patients using omalizumab for longer than 1 year.
  
  
  OBJECTIVE
  To evaluate omalizumab's effectiveness, its feasibility in weaning, and its safety profile in patients with refractory CU who were on omalizumab for longer than 1 year.
  
  
  METHODS
  A retrospective chart review was conducted of adults with well-defined refractory CU in the authors' clinic from October 2005 to January 2015 who responded to omalizumab and who had taken it for longer than 1 year. In addition to baseline characteristics, the duration, course, and adverse effects of omalizumab therapy were analyzed.
  
  
  RESULTS
  Eight of 10 patients had complete resolution of symptoms after reaching their optimal regimen and had taken omalizumab for a median duration of 37 months (17-112 months). None of them required uptitration of dosage, an increase in frequency of dosage, or add-on therapy. Five of 8 patients, while being tapered, had recurrence of symptoms requiring the reuse of omalizumab. One successfully discontinued omalizumab, 1 was in the process of being weaned but did not experience a flare, and 1 had not attempted weaning.
  
  
  CONCLUSIONS
  This study from the United States suggests that omalizumab is effective and safe in patients with refractory CU who use omalizumab for longer than 1 year. Periodic attempts at weaning patients with CU from omalizumab should be attempted because there could be a chance of spontaneous remission. This might be difficult because symptoms are likely to recur, but restarting omalizumab in these patients seems effective and safe.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: Daniel.Har@Phhs.org.
authors.forename: Daniel
authors.initials: D
authors.lastname: Har
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Saurin
authors.initials: S
authors.lastname: Patel
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: David A
authors.initials: DA
authors.lastname: Khan
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab; D007073:Immunoglobulin E