Omalizumab Treatment and Outcomes in Chinese Patients with Chronic Spontaneous Urticaria, Chronic Inducible Urticaria, or Both

Abstract

Chronic urticaria (CU) is a common skin disorder which is further divided into chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). Omalizumab (anti-IgE) therapy is effective and safe for difficult-to-treat CU based on clinical trials but little is known about its use for CU in China. Our study was conducted to collect real-world clinical data on omalizumab treatment in patients with CSU, CIndU and both. This was an observational, retrospective chart review of patients with CU initiating omalizumab treatment between February 2018 and May 2020 (maximum 27 months follow-up). A total of 152 patients were included, 97 with CSU alone, 36 with different forms of CIndU, and 19 with both. A total of 88.2% of the CU patients responded to omalizumab therapy. The response rate was comparable among patients with CSU, CIndU or both. The proportion of patients with low total IgE levels in nonresponders was significantly higher than that of responders (61.1% vs. 16.1%, P<0.001). Besides, there were more patients with elevated thyroid autoantibodies in nonresponders than in responders (50.0% vs. 22.6%, P=0.035). The median ratio of serum IgG-anti-thyroid peroxidase to serum total IgE in nonresponders was significantly higher than in responders (1.22 vs. 0.09, P<0.001). Nonresponders also had shorter treatment periods (4.5 vs 6.0 months, P<0.001) compared with responders. Omalizumab is highly effective in patients with difficult-to-treat CSU, CIndU or both. Responders tend to have unique immunological features and longer treatment periods.