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Chronic Urticaria — SCE Dermatology MCQ

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ModerateInflammatory DermatosesChronic UrticariaSCE Dermatology

A 40-year-old woman has chronic idiopathic urticaria controlled with Omalizumab. She has been well for 6 months. Can Omalizumab be discontinued?

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Correct answer: D — Yes — consider trial of discontinuation after 6 months of good control; may need retreatment if urticaria recurs

EAACI/GA²LEN guidelines recommend considering trial discontinuation of Omalizumab after 6 months of good disease control. Approximately 30-50% of patients may relapse after stopping, requiring retreatment. Re-treatment with Omalizumab after relapse is generally effective. Some patients achieve sustained remission. The decision to discontinue should be shared with the patient. There is no consensus on gradual dose reduction versus abrupt cessation. Response to Omalizumab is typically rapid (within 1-2 weeks), so relapse can be quickly managed with retreatment. Annual reassessment of the need for continued therapy is recommended.

Reference: EAACI/GA²LEN 2022 Urticaria; NICE TA339