Retreatment With Omalizumab Results in Rapid Remission in Chronic Spontaneous and Inducible Urticaria

IMPORTANCE Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment. OBJECTIVE To assess the response of patients with chronic urticaria who receive omalizumab retreatment. DESIGN, SETTING, AND PARTICIPANTS Retrospective analyses were conducted of outpatients treated at an urticaria specialist center of a university hospital. Participants included 25 consecutive patients (aged 18-74 years; 18 women) with chronic spontaneous urticaria, chronic inducible urticaria, or both who showed complete response to omalizumab treatment, experienced relapse after discontinuation of treatment, and received retreatment with omalizumab. INTERVENTIONS Subcutaneous treatment with omalizumab (150-600 mg/mo). MAIN OUTCOMES AND MEASURES Response after retreatment was assessed by the urticaria activity score in patients with chronic spontaneous urticaria and by trigger threshold testing (in patients with cold urticaria or symptomatic dermographism) and/or a carefully determined history (in patients with cholinergic urticaria, solar urticaria, or pressure urticaria). Adverse events were documented. RESULTS All patients experienced complete response after retreatment. None of the patients reported relevant adverse events during omalizumab treatment and retreatment. CONCLUSIONS AND RELEVANCE Omalizumab retreatment is effective and safe in patients with chronic urticaria who have benefited from initial omalizumab treatment.