Analysis of Predictors of Response Degree to Omalizumab in 124 Patients with Chronic Spontaneous Urticaria.

OBJECTIVE

To explore the key predictors of response degree of omalizumab in treating chronic spontaneous urticaria (CSU).

METHODS

A retrospective study was conducted on CSU patients treated with omalizumab in the dermatology department of Shijingshan Hospital, Beijing, from September 2023 to February 2025. Clinical data were collected via outpatient and telephone follow-ups, including demographics, medical history, triggering factors (eg, cold, heat, pressure, sunlight), serum total IgE levels, urticaria control test (UCT), and urticaria activity score 7 (UAS7) before and after treatment. Therapeutic efficacy was categorized as complete response (UAS7=0, UCT=16), markedly effective (UAS7<7, UCT=14-15), and effective (UAS7=8-16, UCT=12-13). Chi-square tests and binary logistic regression were used for statistical analysis.

RESULTS

Multivariate binary logistic regression indicated that triggering factors (none vs. multiple: OR=4.24, 95% CI 1.59-30.64; single vs. multiple: OR=11.41, 95% CI 1.96-66.40), family allergy history (none vs. present: OR=16.47, 95% CI 2.18-124.22), and antihistamine use prior to treatment (multiple vs. none: OR=12.29, 95% CI 2.89-169.48) were significant predictors of response degree (P<0.05). Age, disease duration, BMI, and serum total IgE showed no significant association with treatment outcomes.

CONCLUSION

This single‑center retrospective study identifies clinical predictors of response degree among omalizumab‑treated CSU patients. Patients without family allergy history, with single or no triggering factors, and those using multiple antihistamines prior to treatment show higher degrees of response.