The Expanding Field of Biologics in the Management of Chronic Urticaria

J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1489-1499. doi: 10.1016/j.jaip.2017.05.018. Epub 2017 Jul 19.

Abstract

Chronic urticaria (CU) is the occurrence of urticaria with or without angioedema for at least 6 weeks. Management has traditionally involved antihistamines as first-line therapy with various alternative therapies for refractory cases. Largely based on the success of biologics for various diseases, this class of drugs has come to the forefront of medical research. The first and only Food and Drug Administration-approved biologic for the management of CU is omalizumab (humanized anti-IgE mAb). In the past decade, a substantial amount of research has been centered on the mechanism of action, efficacy, dosing, and safety of omalizumab. This review will focus on the data surrounding the management of CU with omalizumab, off-label use of other biologics for CU, and biologics currently under investigation for use in CU. We will also discuss management considerations and areas of interest for future research.

Keywords: Biologics; Chronic urticaria; Mechanism; Monoclonal antibody; Omalizumab; Safety.

Publication types

  • Review

MeSH terms

  • Angioedema / epidemiology
  • Angioedema / therapy*
  • Anti-Allergic Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Biological Products / therapeutic use*
  • Chronic Disease
  • Histamine Antagonists / therapeutic use
  • Humans
  • Immunoglobulin E / immunology
  • Off-Label Use
  • Omalizumab / therapeutic use
  • United States
  • Urticaria / epidemiology
  • Urticaria / therapy*

Substances

  • Anti-Allergic Agents
  • Antibodies, Monoclonal
  • Biological Products
  • Histamine Antagonists
  • Omalizumab
  • Immunoglobulin E