Is Omalizumab a Safe and Effective Treatment for Chronic Urticaria?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not omalizumab is a safe and effective treatment for chronic urticaria. STUDY DESIGN: Review of two randomized controlled studies and one crossover study. All three studies are published in English between 2008-2011. DATA SOURCES: Two randomized, double blind, placebo controlled studies and one crossover study found using PubMed and EBSCOhost. OUTCOMES MEASURED: Each trial measured the duration, size, number and/or intensity of wheals. This was done by using the urticaria activity score (UAS). Quality of life was also measured using Dermatology Life Quality Index (DLQI), Skindex-29, and Chronic Urticaria Quality of Life Questionnaire (Cu-Q2oL). RESULTS: The first study, the Maurer et al study showed that after 24 weeks of treatment with omalizumab, there was a mean change in UAS7 from baseline of -17.8. Saini et al study showed a mean change in UAS7 from baseline of -19.9 after four weeks of omalizumab treatment. Quality of life measured in the Maurer et al study showed that those treated with omalizumab experienced as least a 50% improvement. No serious adverse events were noted in any of the three studies. Most common adverse events include diarrhea, nasopharyngitis, and headache. CONCLUSION: Based on these three trails, omalizumab is a safe and effective treatment for chronic urticaria. Each study showed a significant improvement of symptoms without any serious side effects when using omalizumab