Update on Omalizumab for Urticaria: What's New in the Literature from Mechanisms to Clinic

Curr Allergy Asthma Rep. 2018 May 9;18(5):33. doi: 10.1007/s11882-018-0787-5.


Purpose of review: Since omalizumab has been approved for urticaria, numerous randomized and real-life observational trials have been published. We reviewed the period January 2017-February 2018.

Recent findings: Omalizumab is effective for the control of urticaria recalcitrant to antihistamines in different populations globally. The ratio of total serum IgE 4-week/baseline ≥2 can predict response with a high likelihood. In observational real-life trials, doses have been adjusted on an individual basis: in some populations, up to two-thirds of the patients can be controlled with 150 mg/month; however, others are still not controlled with 300 mg/month. In these, 150 mg bimonthly could be tried, before up-dosing to 450 mg/month. On the long run (up to 3 years) omalizumab kept its efficacy. In many patients, dosing intervals could be augmented (6-8 weeks, some even more). After a 12-month treatment, about 20% showed long-term remission without relapse. Some biomarkers are being detected. Adjusting omalizumab doses in urticaria patients could enhance efficacy (shortening dosing interval and/or augmenting dose) and save costs (after 12 months: extending dosing interval and/or reducing dose).

Keywords: Adverse events; Chronic inducible urticaria; Chronic spontaneous urticaria; Dosing intervals; Omalizumab; Pregnancy.

Publication types

  • Review

MeSH terms

  • Anti-Allergic Agents / administration & dosage*
  • Anti-Allergic Agents / adverse effects
  • Biomarkers
  • Female
  • HIV Infections / drug therapy
  • Humans
  • Omalizumab / administration & dosage*
  • Omalizumab / adverse effects
  • Pregnancy
  • Urticaria / drug therapy*
  • Urticaria / immunology


  • Anti-Allergic Agents
  • Biomarkers
  • Omalizumab