World Allergy Organization Journal (Nov 2021)

Expert consensus on the use of omalizumab in chronic urticaria in China

  • Zuotao Zhao, MD, PhD,
  • Tao Cai, MD,
  • Hong Chen, MD,
  • Liuqing Chen, MD,
  • Yudi Chen, MD,
  • Xiang Gao, MD,
  • Xinghua Gao, MD,
  • Songmei Geng, MD,
  • Yinshi Guo, MD,
  • Fei Hao, MD,
  • Guodong Hao, MM,
  • Yan Hu, MD,
  • Hongzhong Jin, MD,
  • Zhehu Jin, MD,
  • Chengxin Li, MD,
  • Haili Li, MD,
  • Jie Li, MD,
  • Yanming Li, MD,
  • Yunsheng Liang, MD,
  • Guanghui Liu, MD,
  • Qiang Liu, MD,
  • Hai Long, MD,
  • Lin Ma, MD,
  • Yuanyuan Shang, MM,
  • Yuxin Song, MB,
  • Zhiqiang Song, MD,
  • Xiangyang Su, MD,
  • Haijing Sui, MD,
  • Qing Sun, MD,
  • Yuemei Sun, MB,
  • Jianping Tang, MD,
  • Xunliang Tong, MD,
  • Huiying Wang, MD,
  • Gang Wang, MD,
  • Lianglu Wang, MD,
  • Siqin Wang, MB,
  • Li Xiang, MD,
  • Ting Xiao, MD,
  • Zhiqiang Xie, MD.,
  • Leping Ye, MD,
  • Yongmei Yu, MM,
  • Chunlei Zhang, MD, PhD,
  • Litao Zhang, MD,
  • Shuchen Zhang, MD, PhD,
  • Rui Zheng, MD,
  • Lili Zhi, MM,
  • Wei Zhou, MD,
  • Ying Zou, MD,
  • Marcus Maurer, MD

Journal volume & issue
Vol. 14, no. 11
p. 100610

Abstract

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Chronic urticaria (CU) is a debilitating skin disease that lasts for more than 6 weeks with wheals and/or angioedema, including chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU). In China, the prevalence of this disease is high, more than 1%, and on the rise. CU has a major impact on the quality of life (QoL) of patients who frequently experience sleep disturbance, depression, and anxiety. Nearly one-third of patients with CSU, in China, are resistant to second-generation H1-antihistamines (sgAHs), even at a fourfold dose (second line; off-label). Omalizumab is approved for the treatment of CSU treatment in Europe and shows remarkable efficacy and safety. In China, regulatory approval for the use of omalizumab is pending, and its use in clinical practice varies widely. Consensus on omalizumab CU treatment in China is urgently needed. The aim of this article is to propose a practical omalizumab treatment algorithm for the management of antihistamine-resistant CSU and CIndU in adults and special population including children and adolescents, and pregnant or breast feeding women, to guide daily clinical practice in China. In the development of this consensus, an expert group including mainly dermatologists, allergists, but also pulmonologists, ENTs, immunologists, and pediatricians in Allergic Disease Prevention and Control Committee, Chinese Preventive Medicine Association, reviewed the existing evidence and developed consensus on the use of omalizumab in CU patients from China. The goal of this consensus is to assist clinicians in making rational decisions in the management of refractory CU with omalizumab. The key clinical questions covered by the treatment algorithm are: 1) Omalizumab treatment routine strategy in both CSU and CIndU patients; 2) Recommended dose and treatment duration for different age stratification; 3) Treatment duration for CU patients with other allergic comorbidities; 4) Recommendation on omalizumab stopping strategy.

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