Treatment of Chronic Spontaneous Urticaria: a Focused Update in Omalizumab

Whitney A. Blackwell, David A. Khan

Research output: Contribution to journalReview articlepeer-review


Purpose of review: Chronic spontaneous urticaria (CSU) is a common disease in the general population that causes significant effects on quality of life and a financial burden on the health care system. Guidelines are essential to assure patients are being managed appropriately, although given the rigor to develop these reviews they are not as up to date as cutting-edge scientific evidence. This review details the most recent phase II, III, and IV clinical trials that have been published since the development of the US practice parameters. Recent findings: Phase II, III, and IV clinical trials, ASTERIA I, POLARIS, X-ACT, MoA, and CTEND-CIU, demonstrate safety, long-term efficacy, and improvement in patient’s quality of life by decreasing disease-burdened days and severity of disease in comparison with placebo, as well as transcriptional level changes in gene expression with omalizumab use. Data is emerging regarding efficacy in inducible urticarias, predictors of response, and optimal methods for discontinuation of omalizumab. Summary: Optimal treatment of CSU should be based on recent practice parameters and guidelines. Recent evidence supports the use of omalizumab in antihistamine refractory urticaria patients, but the mechanism for its effect, identification of biomarkers to predict response to therapy, optimal duration, and adjustments in dosing all require additional investigation.

Original languageEnglish (US)
Pages (from-to)175-188
Number of pages14
JournalCurrent Treatment Options in Allergy
Issue number3
StatePublished - Sep 2019


  • Adverse effect
  • Angioedema
  • Omalizumab
  • Treatment
  • Urticaria

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine (miscellaneous)


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