Omalizumab for patients with chronic spontaneous urticaria: A narrative review of current status

Casale, Thomas B.; Giménez Arnau, Anna Maria; Bernstein, Jonathan A.; Holden, Michael; Zuberbier, Torsten; Maurer, Marcus

doi:http://dx.doi.org/10.1007/s13555-023-01040-9

Omalizumab for patients with chronic spontaneous urticaria: A narrative review of current status

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Casale TB, Gimenez-Arnau AM, Bernstein JA, Holden M, Zuberbier T, Maurer M. Omalizumab for patients with chronic spontaneous urticaria: A narrative review of current status. Dermatol Ther (Heidelb). 2023 Nov;13(11):2573-88. DOI: 10.1007/s13555-023-01040-9

Abstract

Chronic spontaneous urticaria (CSU) is a debilitating inflammatory disorder of the skin, characterized by a fluctuating natural history, a complex mechanism of action, and a significant burden on patients, including effect on quality of life, development of psychosocial disorders, and a range of comorbidities. Recent international guidelines recommend a therapeutic approach of first-line treatment with second generation H1-antihistamines and second-line treatment with the biologic omalizumab. Here, the salient aspects of CSU and current status of data for omalizumab for patients with CSU are reviewed, with a focus on mechanism of action, efficacy and real-world effectiveness (including patient outcomes, response, relapse, and remission), and safety (including consideration of the risk of anaphylaxis). The review also considers recent data on COVID-19, CSU, and omalizumab and presents our perspective on future needs. Overall, the data suggest that omalizumab is an effective and well-tolerated treatment for patients with CSU that provides benefits for a wide range of patients.