Many patients with chronic spontaneous urticaria treated with omalizumab were able to reduce their use of concomitant medications and achieve control of symptoms, according to the results of a real-world population study published in the Annals of Allergy, Asthma & Immunology.
A total of 48 patients with chronic urticaria treated with omalizumab for ≥1 year from clinics in Madison, Wisconsin, were enrolled in the study. The study initiated a protocol to allow reductions in omalizumab frequency and dosing, including changing the dosing frequency to every 6 weeks, 8 weeks, or 12 weeks, and the dose from 300 to 150 mg. In the overall cohort (mean age, 49 years), the mean omalizumab treatment duration was 38 months.
Approximately 30% (n=7) of patients reduced their cumulative dose of omalizumab, and 52% (n=12) of patients continued receiving the same dose. A total of 4 (17%) of patients had their omalizumab dose increased to maintain symptom control. Of the patients who had their doses decreased, 71% had a body mass index >31 kg/m2, and 43% had angioedema associated with urticaria. All patients who increased their cumulative dose of omalizumab were obese. Approximately 87% of patients achieved complete symptom control at the last clinic appointment.
A high percentage of patients who took concomitant medications were able to stop or reduce the use of second-generation H1 blockers (48%), first-generation H1 blockers (62%), H2 blockers (65%), montelukast (63%), and daily corticosteroids (79%).
Limitations of the study included the small sample size, as well as the enrollment of patients from clinics within the same University of Wisconsin network.
“For the practicing clinician,” the researchers wrote, “[these] data [support] a concerted clinical effort to tapering the dosage of omalizumab and other [chronic spontaneous urticaria] medications.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
McIntyre AP, Viswanathan RK, Moss MH, Mathur SK. Real world dosing of omalizumab for chronic spontaneous urticaria [published online December 2, 2019]. Ann Allergy Asthma Immunol. doi:10.1016/j.anai.2019.11.028