Practical aspects of treatment with omalizumab in chronic spontaneous urticaria during COVID-19 vaccination campaign

Abstract

Omalizumab is the first monoclonal antibody approved for use in patients with chronic spontaneous urticaria who remain symptomatic despite H1 antihistamine treatment. Recent data on the dosage of this drug in urticaria and practical aspects of subcutaneous administration of prefilled syringes with omalizumab during the COVID-19 vaccination campaign are presented. In our opinion, doses of omalizumab before and after COVID-19 vaccination should be injected subcutaneously in the thigh or abdomen, avoiding the same arm as the site of intramuscular injection of the vaccine. The recommendations for the time intervals between COVID-19 vaccinations and biological treatments are presented in accordance with the Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI) and the German Society of Applied Allergology (AeDA). COVID-19 vaccination should be given between two administrations of omalizumab, preferably with a time lag of at least one week after the previous biological treatment and at least one week before the next planned biological treatment.