Are currently available biomarkers useful to discriminate CSU patients not controlled by low dose omalizumab maintenance therapy?

Summary: In patients with Chronic Spontaneous Urticaria (CSU), low dose omalizumab maintenance therapy is effective in about one half of complete, fast responders to the drug. Omalizumab 150 mg/month was given as maintenance therapy to 21 patients with a history of severe CSU showing a complete (UAS7=0) response to the dose of 300 mg/month. After 2 months of such regimen, patients were divided into controlled (n=14; UAS7=0) and not controlled (n=7; UAS7 greater-than 10) and ESR, CRP, total IgE, and D-dimer were measured. The two groups did not differ in any of the biomarkers considered, nor in disease duration or in pre-treatment UAS7 score. The study confirms that it is possible to halve the dose of omalizumab without any loss of efficacy in a subgroup of patients with CSU but that none of the currently available biomarkers is able to predict which patients will lose disease control following omalizumab dose reduction.

RCT Entities:   Population Interventions Outcomes