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Omalizumab improves solar urticaria physical, psychological symptoms

Use of omalizumab significantly improved the symptoms of solar urticaria as well as improved anxiety and depression scores, according to the results of several recent case studies.

“Omalizumab seems to be a new, promising, well-tolerated effective agent in the treatment of severe [solar urticaria (SU)],” Álvaro de Dios-Velázquez, MD, of the department of dermatology at Complejo Asistencial Universitario de Salamanca, Spain, and colleagues wrote. “However, more studies are needed to specify which patients could benefit from omalizumab treatment.”

Dios-Velázquez and colleagues reported on a case study of a 41-year-old man with severe solar urticaria resistant to a threefold daily dose of 20 mg bilastine and severe sun blockers.

“He developed an eruption of pruritic wheals that rose minutes after sun exposure, mainly on the forearms but also on the hands, neck and face, which disappeared 1 hour after going indoors,” the researchers wrote. “In addition, when sun exposure had been long and intense, he presented with an extended flare of mouth, hands and genitalia edema.”

At baseline, the patient’s Chronic Urticaria Quality of Life Score was 46 of 92 points, and the Hospital Anxiety and Depression Scale scores were 5 of 21 — indicating anxiety — and 8 of 21, indicating depression. The researchers administered 300 mg of omalizumab every 4 weeks and monitored these scores for improvement.

“Within the first 2 weeks, the patient experienced a complete resolution of his symptoms, allowing him long working days outdoors,” Dios-Velázquez and colleagues wrote. “He remained asymptomatic with no other treatment.”

Additionally, the patient’s phototesting results were negative; his Chronic Urticaria Quality of Life Score had improved by 85% (7 of 92 points), and his Hospital Anxiety and Depression Scale scores improved by 80% (1 of 21 points) and 100% (0 of 21 points). The researchers reported that the patient is still asymptomatic after 8 months of treatment and the only adverse effect reported was asthenia a few days after initial administration of omalizumab.

Dios-Velázquez and colleagues also investigated other case studies of omalizumab as a treatment for severe urticaria. Of 13 total patients, nine (69.2%) have responded favorably to treatment, with 1 patient (7.7%) having a partial response and 3 patients (23.1%) having no response to treatment. – by Jeff Craven

Disclosure: Dios-Velázquez reports no relevant financial disclosures. One researcher reports an advisory board role for Faes Farma and Novartis. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.