title: Treatment of Chronic Spontaneous Urticaria with a Single Dose of Omalizumab: A Study of Four Cases.
abstract: BACKGROUND
  Chronic spontaneous urticaria (CSU) has a detrimental effect on patients' emotional and physical quality of life. Omalizumab, an anti-immunoglobulin E humanized monoclonal antibody, has been shown to be very effective in the treatment of refractory chronic urticaria patients but may not be an economically viable option for all CSU patients. However, we present a case series where a single dose of omalizumab gave sustained relief of symptoms in patients with CSU, which may be an economical option.
  
  
  OBJECTIVE
  The aim of this study is to assess the efficacy of a single dose of omalizumab in the treatment of CSU.
  
  
  METHODS
  Four patients of CSU whose disease was not controlled with four times the licensed dose of tablet fexofenadine 180 mg were exhibited one subcutaneous injection of omalizumab and were followed up at 4 weekly intervals for 24 weeks for Weekly Urticaria Activity Score 7 (UAS7) and Dermatology Life Quality Index (DLQI).
  
  
  RESULTS
  A sharp decline in UAS7 and DLQI was documented in 7-10 days. The decline was maintained up to 16 weeks in one case and 20 weeks in the other three cases. Both the scores at the end of the follow-up period of 24 weeks were better than the pre-omalizumab scores.
  
  
  CONCLUSIONS
  The results of this case series indicate the efficacy of a single-dose omalizumab in treating moderate to severe refractory CSU. Further studies are required to identify the minimum frequency of administering omalizumab to effectively control CSU. This would greatly reduce the cost of this novel therapy.
authors: Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India.
authors: Radhakrishnan
authors: R
authors: Subramaniyan
authors: Department of Dermatology, Command Hospital Air Force, Bengaluru, Karnataka, India.
authors: Ajay
authors: A
authors: Chopra
keywords: Chronic spontaneous urticaria; Dermatology Life Quality Index; Urticaria Activity Score 7; omalizumab