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Prognosis and Efficacy of Omalizumab in Acute Urticaria Irresponsive to Systemic Steroids: A Retrospective Analysis
Da-Hyun Kang1, Bark-Lynn Lew1, Soon-Hyo Kwon2
1Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
Background:
Omalizumab is recommended as a second-line therapy for chronic urticaria; however, its role in acute urticaria remains unknown.
Objective:
This study aimed to determine the prognosis of patients with acute urticaria who were irresponsive to systemic steroids and to evaluate the efficacy of omalizumab in acute urticaria.
Methods:
We retrospectively analyzed 64 patients with acute urticaria between March 2020 and February 2022. We classified the patients into two groups according to systemic steroid treatment response. Data on patient demographics, laboratory findings, progression into the chronic phase, and symptom improvement with omalizumab in the steroid-nonresponsive (SNR) group were collected.
Results:
The study included 18 men and 46 women (mean age: 45.47±17.65 years). Among them, 20 patients were irresponsive to systemic steroids. The SNR group had a significantly higher progression rate to chronic urticaria than the steroid-responsive group. In the SNR, 12 patients were treated with omalizumab. More patients treated with omalizumab achieved symptom relief compared with the patients who received systemic steroids.
Conclusion:
Patients with acute urticaria who are irresponsive to systemic steroids are at a higher risk of chronic urticaria progression than steroid-responsive patients. Therefore, omalizumab may be a good therapeutic choice for these patients.