Effectiveness of omalizumab in a case of urticarial vasculitis

• DOI: 10.1111/ced.13076
• Publication Date: 2017-03-01T06:26:56Z
• Authors: A. Fueyo-Casado; L. Campos-Muñoz; E. González-Guerra; J. Pedraz-Muñoz; J. A. Cortés-Toro; E. López-Bran
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Urticarial vasculitis (UV) is a mainly leucocytoclastic vasculitis with urticarial plaques. Treating these patients is challenging as the available treatments have poor efficacy. Oral corticosteroids are considered the first-line treatment, but H1 antihistamines, dapsone, colchicine, antimalarials, ciclosporin and antileucotrienes have all been tried also. However, because of their adverse effects and/or lack of efficacy, new agents are still needed. Omalizumab, an anti-IgE antibody, shows efficacy in chronic spontaneous urticaria, and might also be a good treatment for angio-oedema and urticarial vasculitis. To our knowledge, there have been only seven relevant case reports published in the English literature. We add a new case of severe chronic recurrent urticarial vasculitis refractory to all of the drugs mentioned above. We started the patient on subcutaneous omalizumab 300 mg every 4 weeks, which produced clinical improvement within the first month and total remission in the fifth month. The patient has remained stable for 23 months, and follow-up is ongoing.