Experience of using genetically engineered biological therapy in the treatment of chronic urticaria

Background: сhronic spontaneous urticaria (CSU) constitutes a socially significant disease not only due to its high prevalence but also because it predominantly affects individuals of working age, incurs substantial financial costs for treatment, and exhibits the absence of standardized diagnostic and therapeutic protocols. Aim: to analyze clinical experience in achieving remission or disease control in patients with severe CSU through the use of omalizumab. Materials and Methods: the study enrolled 30 patients, including 8 males, with a median age of 48 years [33; 55] and a median disease onset of 32 years [20.5; 40.75] (with a disease duration of over 12 months). Urticaria symptom severity was assessed using the UAS-7 questionnaire at baseline and throughout the follow-up period. Results: patients were initially treated with double doses of second-generation antihistamines and systemic corticosteroids (as needed), without achieving significant symptom improvement. At the initiation of omalizumab therapy, the median UAS-7 score was 41 points [35,25; 42]. Treatment with omalizumab resulted in partial or complete disease control, the discontinuation of systemic glucocorticosteroids, and partial or complete withdrawal of second-generation antihistamines. Early clinical remission was achieved in 40% of patients, while 50% exhibited a delayed response, with a substantial reduction in urticaria activity occurring after eight weeks of treatment. Conclusion: the results of this study underscore the high efficacy of omalizumab as a targeted immunobiological therapy in patients with severe CSU KEYWORDS: chronic spontaneous urticaria, chronic induced urticaria, antihistamines, omalizumab, therapy efficacy. FOR CITATION: Sobko E.A., Demko I.V., Kraposhina A.Yu., Chernykh V.A. Experience of using genetically engineered biological therapy in the treatment of chronic urticaria. Russian Medical Inquiry. 2025;9(2):105–111 (in Russ.). DOI: 10.32364/2587-6821-2025-9-2-2