{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:57:09Z","timestamp":1790521029625,"version":"4.1.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Omalizumab is a highly effective third-line treatment for chronic spontaneous urticaria (CSU) refractory to antihistamines. However, disease relapse upon cessation is a significant clinical challenge. Real-world evidence comparing different discontinuation strategies is scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective, multicenter, real-world study evaluated 199 patients with refractory CSU treated with omalizumab (300\u2009mg\/month) in the Piedmont-Aosta Valley region. We assessed effectiveness using Urticaria Activity Score (UAS\/UAS7) and Dermatology Life Quality Index (DLQI). The primary outcomes were response rates, relapse rates after abrupt discontinuation versus gradual dose spacing, and predictors of these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Omalizumab demonstrated high effectiveness, achieving a complete response rate of 71% after the first treatment cycle, with drastic reductions in mean UAS7 (from 28.8 to 4.3) and DLQI (from 25.3 to 0.8) by month 4. Abrupt discontinuation resulted in a high relapse rate of 73.7%, with a short median time to recurrence of 2\u2009months. Multivariate analysis found no significant baseline predictors of response. Counterintuitively, a higher baseline UAS7 was associated with a lower risk of relapse. A subgroup of 48 patients, characterized as \u201csuper-responders,\u201d underwent gradual dose spacing. This group achieved a significantly lower relapse rate of 27.1% after abrupt cessation, without significant symptomatic worsening during tapering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Omalizumab is an effective control therapy for CSU in a real-world setting. Abrupt discontinuation leads to rapid relapse in the majority of patients. Gradual dose spacing represents a promising strategy to prolong remission and reduce drug burden, particularly in patients exhibiting excellent initial therapeutic response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/12034754261484533","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:04:16Z","timestamp":1790312656000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Omalizumab Discontinuation in Chronic Spontaneous Urticaria: Effectiveness and Predictors of Response and Relapse Comparing Abrupt Cessation and Dose Spacing in a Retrospective Real-Life Study"],"prefix":"10.1177","author":[{"given":"Silvia","family":"Borriello","sequence":"first","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Brizio","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Frassy","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Rosset","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Sciamarrelli","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Borrelli","sequence":"additional","affiliation":[{"name":"SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Sardanelli","sequence":"additional","affiliation":[{"name":"SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Lappi","sequence":"additional","affiliation":[{"name":"SSD Dermatologia e Allergologia, Ospedale Beauregard, Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Quaglino","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Ribero","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7386-3219","authenticated-orcid":false,"given":"Luca","family":"Mastorino","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Medical Sciences, University of Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"11","key":"e_1_3_2_2_2","first-page":"717","article-title":"Acute and chronic urticaria: evaluation and treatment","volume":"95","author":"Schaefer P.","year":"2017","unstructured":"Schaefer P. 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