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Omalizumab can be used for when urticaria will not go away.
Chronic urticaria is itchy hives or a nettle-sting like rash that lasts 6 weeks or more. There is no known cause.
Treatments for this include antihistamines (such as cetirizine, loratadine, fexofenadine) and, sometimes leukotriene antagonist therapy (such as Montelukast).
Children over the age of 12 years who have not responded to standard treatment may be offered omalizumab.
Omalizumab is an antibody that works by binding to all different types of allergy (called IgE) antibodies in the blood.
It stops the antibody from attaching to some cells, which stops them from releasing too much histamine and other inflammatory substances which cause the urticarial rash.
Omalizumab (also known by brand name Xolair®) is given as an injection into the tissue under the skin, usually in the upper arm.
For urticaria, this is given as 2 pre-filled 150 mg injections, every 4 weeks.
Response to treatment varies. It may take anywhere between 1 to 4 months to notice any improvement in symptoms.
Children will be assessed after the 4 dose to see if it is beneficial.
If the symptoms have not improved, then the medication is unlikely to work and will be stopped.
If there is a clear benefit, the injections will be continued for another 2 months before being stopped.
The omalizumab injections may be restarted if symptoms return in 6 monthly blocks.
Like all medications, omalizumab can cause side effects.
The most common side effects include:
These can happen in up to 1 in 10 children and are usually mild.
Less common side effects happen in up to 1 in 100 people and include:
Rare side effects happen in less than 1 in 1000 people and can include:
There is also an increased risk of a parasitic or worm infection, so please contact the team if you are planning to travel.
It is very important to make the team aware if there any chance of your child being pregnant.
Your doctor will discuss the side effects and you will have a chance to ask questions before signing a consent form.
If you have any questions or concerns, please contact:
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
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