Therapeutic strategy according to differences in response to omalizumab in patients with chronic spontaneous urticaria giménez

A. M. Arnau, A. Valero Santiago, J. Bartra Tomás, I. Jáuregui Presa, M. Labrador-Horrillo, F. J. Miquel Miquel, J. Ortiz De Frutos, J. Sastre, J. F. Silvestre Salvador, M. Ferrer Puga

Research output: Contribution to journalReview articleResearchpeer-review

15 Citations (Scopus)


© 2019 Esmon Publicidad. Chronic spontaneous urticaria (CSU) is a heterogeneous condition that can severely impact quality of life. Consequently, rapid disease control is essential. First-line treatment of the symptoms of CSU is the licensed dose of second-generation H1 antihistamines. For second-line treatment, this dose may be increased by up to 4 times. In patients who fail to respond to higher doses of H1 antihistamines, omalizumab for up to 24 weeks is recommended to achieve disease control. After this 24-week period, the patient’s response to omalizumab should be assessed in order to identify refractory patients. Optimal management of refractory patients has not been established. Therefore, the aim of the present consensus document, which was drafted by allergists and dermatologists with specific expertise in treating urticaria, was to define specific patient profiles based on differences in their response to omalizumab. We also developed a treatment algorithm based on the specific response profile. After a comprehensive literature review, a group meeting was held to discuss issues related to the therapeutic management of patients with CSU that had not been addressed in previous studies. The experts considered both the available evidence and their own clinical experience with omalizumab. We believe that implementation of the proposed algorithm will optimize management of CSU patients who are refractory to antihistamines, reduce disease-related costs, and improve quality of life.
Original languageEnglish
Pages (from-to)338-348
JournalJournal of Investigational Allergology and Clinical Immunology
Issue number5
Publication statusPublished - 1 Jan 2019


  • Chronic urticaria. Antihistamines. Omalizumab. Algorithm. Treatment


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