title: Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature.
abstract: Omalizumab is recombinant humanized monoclonal antibody to immunoglobulin E. Guidelines for the treatment of chronic idiopathic urticaria (also known as chronic spontaneous urticaria) recommend the use of omalizumab as third-line therapy in addition to high doses of histamine receptor type 1 (H1) antihistamines when they are unsuccessful as first- and second-line therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of omalizumab for the treatment of chronic idiopathic urticaria, in both controlled and real-world settings, to assess its potential role as a preferred therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer-reviewed journals in the English language, and 29 studies were included in this review. Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the drug. However, as published studies of omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio, omalizumab could become the preferred method of treatment for chronic idiopathic urticaria in patients unresponsive to H1antihistamines.
authors.affiliation: Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), Pisa, Italy.
authors.forename: Alessandro
authors.identifier: http://orcid.org/0000-0001-8335-5541
authors.initials: A
authors.lastname: Tonacci
authors.affiliation: Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), Pisa, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Billeci
authors.affiliation: Institute of Applied Sciences and Intelligent Systems "Eduardo Caianiello" (ISASI), National Research Council of Italy (CNR), Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pioggia
authors.affiliation: Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Navarra
authors.affiliation: Institute of Applied Sciences and Intelligent Systems "Eduardo Caianiello" (ISASI), National Research Council of Italy (CNR), Messina, Italy.|School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", Messina, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Gangemi
mesh_terms: D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007073:Immunoglobulin E / Q000009:adverse effects / Q000276:immunology; D000069444:Omalizumab / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D014581:Urticaria / Q000188:drug therapy* / Q000276:immunology
chemical_list: D018926:Anti-Allergic Agents; D000069444:Omalizumab; D007073:Immunoglobulin E
keywords: anti-IgE antibody; chronic idiopathic urticaria; chronic spontaneous urticaria; omalizumab; urticaria