title: Position statement for the use of omalizumab in the management of chronic spontaneous urticaria in Indian patients.
abstract: Chronic spontaneous urticaria (CSU) affects 1% of the world population and also their quality of life, and 50% of these patients are refractory to H1-antihistamines. Omalizumab is a humanized monoclonal anti-IgE antibody that binds with free IgE antibodies and reduces the circulating levels of free IgE. This reduction in free IgE prevents mast-cell degranulation. The EAACI/GA2LEN/EDF/WAO guidelines recommend omalizumab as the third-line of therapy as an add-on to antihistamines. The recommended dose of omalizumab is 300 mg, 4 weekly in the management of CSU refractory to standard of care with H1-antihistamines in adults and adolescents ≥12 years of age. In some patients, a dose of 150 mg may be acceptable. Omalizumab has a good safety profile. However, due to the biologic nature of the drug, all patients administered omalizumab must be observed for 2 h after administration for anaphylactoid reactions. There have been no studies on the effect of impaired renal or hepatic function on the pharmacokinetics of omalizumab. While no particular dose adjustment is recommended, omalizumab should be administered with caution in these patients.
authors.affiliation: Department of Dermatology, Dr. D. Y. Patil Medical College and Hospital, Mumbai, Maharashtra, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Godse
authors.affiliation: Department of Dermatology, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Murlidhar
authors.initials: M
authors.lastname: Rajagopalan
authors.affiliation: Department of Dermatology, Max Super Speciality Hospital, New Delhi, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Girdhar
authors.affiliation: Department of Dermatology, Batra Hospital, New Delhi, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Kandhari
authors.affiliation: Department of Dermatology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Bela
authors.initials: B
authors.lastname: Shah
authors.affiliation: Department of Research, Institute of Pulmonology, Medical Research and Development, Mumbai, Maharashtra, India.
authors.forename: Prashant N
authors.initials: PN
authors.lastname: Chhajed
authors.affiliation: Dr. Sushil Tahiliani Clinic, Mumbai, Maharashtra, India.
authors.forename: Sushil
authors.initials: S
authors.lastname: Tahiliani
authors.affiliation: Dr. Krupa Shankar Skin Diagnosis Center, Mallige Medical Centre Pvt. Ltd., Bengaluru, Karnataka, India.
authors.forename: D S Krupa
authors.initials: DS
authors.lastname: Shankar
authors.affiliation: Somani Skin Care Centre, Hyderabad, Telangana, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Somani
authors.affiliation: Skin Diseases Center, Nashik, Maharashtra, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Zawar
keywords: Chronic spontaneous urticaria; guidelines; omalizumab