D2.356 - Real-life effectiveness of omalizumab and its impact on quality of life in patients with chronic spontaneous urticaria

Chronic spontaneous urticaria (CSU) is defined by the presence of recurrent urticaria, angioedema, or both for six weeks or longer without identifiable triggers. Omalizumab is a monoclonal antibody targeting IgE, indicated as adjunctive therapy for patients with CSU unresponsive to maximal treatment with antihistamines. While the efficacy of omalizumab in CSU management is well established, further insights are needed into the predictive factors for treatment outcomes, response timing, and the influence of the medication on quality of life.

This observational retrospective study evaluated the effectiveness of omalizumab in 76 CSU patients over a five-month treatment cycle. Disease activity was assessed using the Urticaria Activity Score 7 (UAS7). Subsequently, patients were stratified into distinct response groups: very early, showing significant improvement within one week; early, achieving results within four weeks; and non-early, if their response occurred later. Groups were compared based on medical histories, allergological comorbidities, and laboratory findings, including eosinophil counts, IgE levels, markers for infections, and autoimmunity. Visual Analog Scales (VAS) were finally employed to assess quality of life across its various dimensions. 

Of the 76 patients included in the study, 34.3% achieved complete remission following the initial 5-month treatment cycle. The majority of the parameters assessed did not demonstrate a significant correlation with treatment response. However, the presence of anti-thyroid antibodies was identified as a factor associated with a delayed response to therapy. The assessment of quality of life revealed noteworthy improvements across several domains, including occupational or academic performance. Particularly, significant benefits were observed in body image perception and self-esteem, highlighting the multidimensional impact of omalizumab on patients beyond symptom control.

The study highlighted the complexity of therapeutic management in CSU, without identifying significant predictors of treatment response. However, it demonstrated that omalizumab provides substantial benefits not only in terms of clinical symptomatology but also in improving various domains of quality of life in patients with CSU. Further research on potential predictive biomarkers and long-term treatment outcomes is warranted to optimize therapeutic strategies and enhance patient management.