Retreatment with omalizumab results in rapid remission in chronic spontaneous and inducible urticaria.

IMPORTANCE: Omalizumab has emerged as a novel and effective treatment option for patients with antihistamine-resistant chronic urticaria. It is unclear whether patients with recurrent urticaria symptoms after discontinuation of omalizumab treatment can benefit from retreatment.

OBJECTIVE: To assess the response of patients with chronic urticaria who receive omalizumab retreatment.

DESIGN, SETTING, AND PARTICIPANTS: Retrospective analyses were conducted of outpatients treated at an urticaria specialist center of a university hospital. Participants included 25 consecutive patients (aged 18-74 years; 18 women) with chronic spontaneous urticaria, chronic inducible urticaria, or both who showed complete response to omalizumab treatment, experienced relapse after discontinuation of treatment, and received retreatment with omalizumab.

INTERVENTIONS: Subcutaneous treatment with omalizumab (150-600 mg/mo).

MAIN OUTCOMES AND MEASURES: Response after retreatment was assessed by the urticaria activity score in patients with chronic spontaneous urticaria and by trigger threshold testing (in patients with cold urticaria or symptomatic dermographism) and/or a carefully determined history (in patients with cholinergic urticaria, solar urticaria, or pressure urticaria). Adverse events were documented.

RESULTS: All patients experienced complete response after retreatment. None of the patients reported relevant adverse events during omalizumab treatment and retreatment.

CONCLUSIONS AND RELEVANCE: Omalizumab retreatment is effective and safe in patients with chronic urticaria who have benefited from initial omalizumab treatment.