Omalizumab (Xolair) is being used to treat chronic hives (urticaria). Chronic idiopathic/spontaneous urticaria (CIU/CSU) is characterized by the spontaneous appearance of hives, angioedema or both that recur without specific external stimuli for at least 6 weeks. Angioedema, which is the acute deeper swelling of the lower skin or subcutaneous tissue has been reported to occur in approximately 40% of patients with CIU/CSU.
Antithistamines have been available to treat hives. Nonsedating antihistamines are used more now to threat hives. Although being used up to 4 times a day of antihistamines, many patients still remain symptomatic with hives and urticaria.
Omalizumab is a humanized anti-IgE monoclonal antibody that is used as add-on therapy for the treatment of chronic hives in adults and adolescents at least 12 years of age with inadequate response to H1 antihistamines.
A recent study published in the Annals of Allergy Asthma and Immunology showed the results of patients with chronic hives and angioedema treated with Omalizumab. These patients have failed H1-antihistamines up to 4 times a day plus Singulair.
Conclusion: Treatment with 300mg of omalizumab was efficacious in reducing patient-reported angioedema for patients with chronic idiopathic urticaria/chronic spontaneous urticaria, who were symptomatic despite a variety of treatments. Most patients reported that they did nothing or took H1-antihistamines to mange their angioedema if they got them. There were a few reports of high intensity interventions for angioedema management.
In summary, treatment with 300 mg of omalizumab can help patients with chronic hives and angioedema in whom antihistamine treatment is failing by reducing the number of days with angioedema they experience. If you are experiencing hives, contact your local allergist or allergy doctor to explore what treatment options are best for you. In this article we have discussed chronic hives, which is different from acute hives (urticaria). Acute hives is defined as hives for less than 6 weeks duration. The work up, management and treatment of acute hives differs from chronic urticaria. Xolair (omalizumab) is not indicated for acute hives.