What Is the Appropriate Omalizumab Duration to Prevent Recurrent Hives?

Individuals with chronic idiopathic urticaria (CIU) are typically administered omalizumab, 300 mg, for approximately 14 months, according to a new study. And a majority of those who stop treatment have to restart because of recurrent symptoms.

To determine the treatment patterns of omalizumab in patients with CIU, the researchers identified 1096 participants from the Allergy Partners Clinic Network EMR (2007-2018) with CIU. The participants were aged 12 years or older, had initiated omalizumab treatment, and had at least 6 months’ worth of data.

After identifying the participants, the researchers analyzed for the continuous treatment duration, discontinuations (defined as having a gap of 90 or more days between consecutive administrations or the last administration and the end of follow-up), and restarts.

The participants’ treatment activity was followed for a mean of 19 months after their treatment initiation.

The study revealed that 89.7% of participants initiated omalizumab on a 300 mg dose, while 5.3% initiated the treatment at 150 mg.

After evaluating for frequency of administration in 1072 participants with 2 or more omalizumab administrations, the researchers determined that the mean frequency of administration was 32.5 days. Further, when assessing the same participants for dose change, the researchers concluded that 68 participants had a dose increase, while 129 participants had a dose decrease.

Participants continued with the treatment for a mean 14.2 months, with 79.6% of participants receiving omalizumab continuously up to 6 months, 63.4% for up to 9 months, and 49.1% for up to 1 year.

Of the 38.5% participants who discontinued omalizumab, 55.5% of them restarted it after a mean of 157.4 days.

—Colleen Murphy

Reference:

Stone BD, Kavati A, Zhdanava M, et al. Omalizumab treatment patterns in chronic idiopathic urticaria (CIU): evidence from a large allergy practice in the United States (US). J Allergy Clin Immunol Pract. 2019;143(2):AB430. https://doi.org/10.1016/j.jaci.2018.12.973.