Omalizumab is recombinant humanized
monoclonal antibody to
immunoglobulin E. Guidelines for the treatment of
chronic idiopathic urticaria (also known as
chronic spontaneous urticaria) recommend the use of
omalizumab as third-line
therapy in addition to high doses of
histamine receptor type 1 (H1 )
antihistamines when they are unsuccessful as first- and second-line
therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of
omalizumab for the treatment of
chronic idiopathic urticaria, in both controlled and real-world settings, to assess its potential role as a preferred
therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer-reviewed journals in the English language, and 29 studies were included in this review.
Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of
chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the
drug. However, as published studies of
omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio,
omalizumab could become the preferred method of treatment for
chronic idiopathic urticaria in patients unresponsive to H1
antihistamines.