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Treatment of chronic idiopathic urticaria (CIU; also called spontaneous urticaria) is frustrating. Standard treatments — diet therapy, H1 or H2 antihistamines, even the immunosuppressive agents cyclosporin, methotrexate, and mycophenolate — are often ineffective or poorly tolerated. The biologic agent omalizumab, approved for asthma therapy, blocks the binding of IgE to its high-affinity receptor, reducing the release of histamine and other inflammatory mediators from basophils and mast cells. Earlier findings suggested that repeated use produced better efficacy although optimal dosing and frequency were unknown.
In this phase 3, multicenter, double-blind, manufacturer-funded study, 323 patients with moderate-to-severe CIU who remained sympt…