Abstract
Most chronic spontaneous urticaria (CSU) patients are female, and pregnancy can aggravate the disease activity of patients, but little is known about the efficacy and safety of omalizumab in pregnant CSU patients. We report two pregnant CSU patients treated with omalizumab and review the published information on omalizumab treatment during 11 pregnancies. The outcomes reported on patients with known pregnancies showed they had normal pregnancies and healthy babies as well as complete control of their CSU. The two new cases we reported support the view that omalizumab could be an effective and safe treatment option for pregnant and breastfeeding CSU patients. Further high-quality studies need to be carried out in order to obtain more information on the long-term efficacy and safety of the use of omalizumab during pregnancy in patients with chronic urticaria, including CSU.
Highlights
Chronic spontaneous urticaria (CSU) is a heterogeneous disorder with recurrent pruritic wheals and angioedema or both that markedly affects patients’ quality of life [1, 2]
Most chronic spontaneous urticaria (CSU) patients are female, and little is known about the efficacy and safety of omalizumab in pregnant CSU patients
We decreased the dose to 300 mg/month, and complete control was maintained by this treatment until January 2020, when patient #2 experienced severe exacerbation of CSU phenotype (UCT:1; Dermatology Life Quality Index (DLQI):12; Cu-Q2ol:65) and was found to be 12 weeks pregnant
Summary
Chronic spontaneous urticaria (CSU) is a heterogeneous disorder with recurrent pruritic wheals and angioedema or both that markedly affects patients’ quality of life [1, 2]. The first patient is a 33-year-old woman diagnosed with CSU and comorbid symptomatic dermographism 2 years ago She had a history of spontaneously occurring recurrent pruritic. As Patient #1 did not consent to the use of a higher than standard dosed antihistamine, we initiated treatment with omalizumab, in June 2020, at 300mg/month, which led to complete control as assessed by the use of the urticaria control test (UCT). We increased the dose of a second application after 4 weeks to 450 mg, which led to complete recovery within 3 days for 3 months, at 450 mg/month (UCT:; DLQI:0; CU-Q2ol:). We decreased the dose to 300 mg/month, and complete control was maintained by this treatment until January 2020, when patient #2 experienced severe exacerbation of CSU phenotype (UCT:; DLQI:; Cu-Q2ol:65) and was found to be 12 weeks pregnant. It was approved by the Chinese Ethics Committee of Registering Clinical Trial (ChiECRCT20190131) and registered with the Chinese clinical trial registry (ChiCTR1900024869)
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