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

作者：Zhao, Zuotao; Cai, Tao; Chen, Hong; Chen, Liuqing; Chen, Yudi; Gao, Xiang; Gao, Xinghua; Geng, Songmei; Guo, Yinshi; Hao, Fei; Hao, Guodong; Hu, Yan; Jin, Hongzhong; Jin, Zhehu; Li, Chengxin; Li, Haili; Li, Jie; Li, Yanming; Liang, Yunsheng; Liu, Guanghui; Liu, Qiang; Long, Hai; Ma, Lin; Shang, Yuanyuan; Song, Yuxin; Song, Zhiqiang; Su, Xiangyang; Sui, Haijing; Sun, Qing; Sun, Yuemei; Tang, Jianping; Tong, Xunliang; Wang, Huiying; Wang, Gang; Wang, Lianglu; Wang, Siqin; Xiang, Li; Xiao, Ting

来源：World Allergy Organization Journal, 2021, 14(11): 100610.

DOI：10.1016/j.waojou.2021.100610

• Chronic spontaneous urticaria
• Chronic inducible urticaria
• Treatment algorithm
• Omalizumab
• China

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 H-1-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.

• 单位
  中国人民解放军第四军医大学; 华中科技大学; 中国医学科学院北京协和医院; 青岛大学; 同济大学; 浙江大学; 中国医科大学; 北京大学; 武汉大学; 南方医科大学; 西安交通大学; 河北医科大学; 山东大学; 上海交通大学; 中山大学