Omalizumab in Chronic Idiopathic Urticaria: Systematic review of clinical trials, evaluation of real-life studies and case reports

Actual guidelines for the treatment of Chronic idiopathic/spontaneous urticaria (CIU/CSU) foreseen the use of Omalizumab as a third-line therapy in addition to high doses of antihistamines, in case they are unsuccessful as a first- and second-line therapy. A systematic review about Omalizumab in the treatment of CIU was performed to define its efficacy both in controlled settings and in real-life studies, and to assess its potential role as a preferred method in future care. PubMed, ScienceDirect, LILACS and Google Scholar between January 1, 2000 and November 21, 2016 (PROSPERO protocol CRD42016035512) were searched. Omalizumab 300 mg administered every 4 weeks appears as the most efficient, quick and safe dosing in treating CIU, for both patients and their offspring, with few slight side-effects on patients' health. However, as works published are still few, future studies are warranted, both in controlled settings and in real life-like situations. When findings are confirmed on larger groups, thanks to its efficacy and low cost, Omalizumab could become the preferred method for the treatment of CIU in patients unresponsive to H1-antihistamines.