What is the role of monoclonal antibodies in the treatment of chronic urticaria?

Updated: Jul 31, 2018
  • Author: Marla N Diakow, MD; Chief Editor: William D James, MD  more...
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Omalizumab (Xolair) was approved by the US Food and Drug Administration (FDA) in March 2014 for chronic idiopathic urticaria in adults and children aged 12 years or older who remain symptomatic despite anti-H1 antihistamine treatment. It is a monoclonal antibody that selectively binds to immunoglobulin E (IgE) and inhibits binding to IgE receptors on the surface of mast cells and basophils. The efficacy and safety of omalizumab for chronic idiopathic urticaria was demonstrated in 2 clinical studies that showed omalizumab significantly improved the mean weekly itch severity score (ISS) from baseline by 9.4-9.6 in the 300-mg treatment arm, by 6.4-6.7 in the 150-mg treatment arm, and by 5.9-6.5 in the 75-mg treatment arm, compared with an improvement of 3.6-5.1 in patients on placebo. [37, 38]

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