LAUSR

Omalizumab is a monoclonal anti-IgE antibody currently used in the treatment of chronic spontaneous urticaria (CSU) as a third-line option in cases refractory to treatment with the licensed dose of the first-line treatment or up to 4 times that dose. The introduction of omalizumab into the therapeutic arsenal for CSU brought about a real revolution in the management of this condition. However, the dose recommended in the Summary of Product Characteristics----based on the results of pivotal studies carried out as part of the approval process----is 300 mg/mo for a period of up to 6 months. In the present issue, the Catalan-Balearic working group presents a treatment algorithm to guide the use of omalizumab in the management of CSU. They discuss the various aspects of management related to the rational and evidence-based use of this drug, including candidate population, monitoring tools (Urticaria Activity Score 7 [UAS7] and Urticarial Control Test [UCT]), starting dose and dose adjustment as well as the definition of response and response time. In a novel approach, the authors of the algorithm propose the use of an increased dose of 450 or 600 mg every 4 weeks if the licensed doses do not achieve adequate control of