title: Omalizumab therapy for treatment of recalcitrant chronic spontaneous urticaria in an Asian population.
abstract: OBJECTIVE
  There are limited data regarding omalizumab in the treatment of recalcitrant chronic spontaneous urticaria (CSU) in Asian populations. This study evaluated the effectiveness and the proper dosage of omalizumab for Asian CSU patients in a real-life setting.
  
  
  METHODS
  We retrospectively reviewed recalcitrant CSU patients seeking treatment at the Skin Allergy Clinic, Siriraj Hospital during the 3-year period. All patients were treated with omalizumab as an add-on therapy. Standard seven-day urticaria activity score (UAS7) and medication score were used to assess omalizumab response.
  
  
  RESULTS
  Of 13 patients, 9 patients (70%) responded well to 150 mg omalizumab injection every month, whereas 4 patients requiring updosing to 300 mg. In the 150 mg group, one patient achieved complete symptom control without antihistamine intake. Most of them required antihistamines without prednisolone and ciclosporin. Onset of omalizumab was fast, usually within the first week. Though only two patients in the 300 mg group achieved complete absence of symptoms, ciclosporin and oral corticosteroids could be discontinued. No patients reported adverse effects.
  
  
  CONCLUSIONS
  Omalizumab at an initial dosage of 150 mg was effective in the treatment of recalcitrant CSU among Asians. Updosing to 300 mg was required to achieve satisfactory outcomes.
authors.affiliation: a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Kanokvalai
authors.initials: K
authors.lastname: Kulthanan
authors.affiliation: a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Papapit
authors.initials: P
authors.lastname: Tuchinda
authors.affiliation: a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Leena
authors.initials: L
authors.lastname: Chularojanamontri
authors.affiliation: a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Chayanee
authors.initials: C
authors.lastname: Likitwattananurak
authors.affiliation: a Department of Dermatology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors.forename: Chanida
authors.initials: C
authors.lastname: Ungaksornpairote
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy*
chemical_list: D018926:Anti-Allergic Agents; D061067:Antibodies, Monoclonal, Humanized; D006634:Histamine H1 Antagonists; D000069444:Omalizumab; D016572:Cyclosporine; D011239:Prednisolone
keywords: UAS7; omalizumab; quality of life; recalcitrant chronic spontaneous urticaria