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Omalizumab (Xolair), a biologic agent previously approved for use in patients with asthma, has been studied over the past several years for use in patients with refractory chronic idiopathic urticaria (NEJM JW Dermatol Mar 1 2013). Previously, this drug was approved for delivery only in the offices of allergists or immunologists. This new approval1 allows other physicians to utilize the drug; however, the package insert still carries a black box warning that recipients should be monitored for post-injection anaphylaxis. The American Academy of Allery, Asthma, and Immunology guidelines on omalizumab administration liberalize the recommended observation times after the first several injections.
Administration for chronic idiopathic urticarial …