An observational study on the efficacy of single injection of omalizumab in the treatment of chronic spontaneous urticaria.

Abstract

Chronic Spontaneous Urticaria (CSU) is one of the most challenging therapeutic problems faced by dermatologists. Omalizumab is a third line drug for CSU which is currently recommended as monthly injections for 6 months. To study the efficacy of single injection of Omalizumab in the treatment of CSU. This was a prospective single center observational study. Single dose of injection Omalizumab 300 mg was administered to 30 patients of CSU on double the dose of tablet Fexofenadine 180 mg with Urticaria Activity Score (UAS-7) more than 15 and their response was assessed using UAS-7 up to 6 months. The mean duration of response of early and late responders were analyzed. Of the 30 patients who completed the study, 29 patients (96.7%) were responders and one (3.3%) was nonresponder. Of the 29 responders, 21 (70%) were early responders and eight (26.7%) late responders. The mean total symptom free durations amongst early and late responders were analyzed and were found significant. The prolonged symptom free intervals in early responders after single injection of Omalizumab followed by antihistamines not only prevented over treatment with Omalizumab but was also cost saving in the long-term management of these cases. With careful monitoring of UAS7 scores an individualized, cost-effective approach can be adopted in the treatment of CSU. This study provides a basis for larger studies and may eventually determine a new standard of care with respect to limiting the doses of a biologic.