{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:26:42Z","timestamp":1792762002148,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Omalizumab is an effective treatment for chronic spontaneous urticaria (CSU), but strategies and predictors for guiding long\u2010term management and discontinuation remain limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine real\u2010world treatment patterns, including dosing modifications and discontinuation, and identify potential predictive factors for these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, observational, real\u2010life study of adult patients with CSU treated with omalizumab at a Urticaria Center of Reference and Excellence (UCARE) in Copenhagen, Denmark, between May 20, 2015, and April 4, 2024. The Kaplan\u2010Meier estimator was used to visualize time to discontinuation and dose escalation\/reduction (using standard label dosing as reference), and Cox\u2010regressions with hazard ratios (HR) were used to investigate potential predictive variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 430 patients initiated on omalizumab, 139 (32.4%) escalated treatment, 161 (37.5%) reduced treatment, and 90 (21.0%) discontinued treatment directly from the standard dose. The median survival time for dose escalation was 2\u2009years (95% CI: 1.17\u20133.55), and the strongest predictor was a positive basophil histamine release assay (BHRA) (HR: 2.79, 95% CI: 1.69\u20134.61). Fast treatment response (HR: 0.50, 95% CI: 0.33\u20130.75) and higher baseline UCT scores (HR: 0.89, 95% CI: 0.82\u20130.97) decreased the risk of dose escalation. The median survival time to dose reduction was 1.2\u2009years (95% CI: 0.98\u20131.49) and was more likely in males (HR: 1.68, 95% CI: 1.13\u20132.50) and patients with fast treatment response (HR: 1.66, 95% CI: 1.12\u20132.48). Median survival time to discontinuation (all reasons) of omalizumab was 3\u2009years (95% CI: 2.35\u20133.64).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A considerable proportion of patients with CSU require modifications to the recommended omalizumab dosing regimen. A positive BHRA was the strongest predictor for dose escalation, while male sex and fast treatment response were the strongest predictors for dose reduction. Our study highlights the need for individualized strategies in managing CSU.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.20737","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T06:14:12Z","timestamp":1747116852000},"page":"1796-1805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Omalizumab dosing patterns and drug survival in adult patients with chronic spontaneous urticaria"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0742-743X","authenticated-orcid":false,"given":"Ditte Georgina","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia\u2010Louise","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Astrup","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2612-5307","authenticated-orcid":false,"given":"Somaia","family":"Naassan","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Vestergaard","sequence":"additional","affiliation":[{"name":"Department of Dermatology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2801-0959","authenticated-orcid":false,"given":"Emek","family":"Kocat\u00fcrk","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t Zu Berlin  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Immunology and Allergology  Berlin Germany"},{"name":"Bah\u00e7e\u015fehir University School of Medicine Department of Dermatology  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2411-7177","authenticated-orcid":false,"given":"Zarqa","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-1743","authenticated-orcid":false,"given":"Jacob P.","family":"Thyssen","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital  Copenhagen Denmark"},{"name":"Department of Clinical Medicine Faculty of Health 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