Omalizumab Shows Median 3.1-Year Drug Survival in Chronic Urticaria
Key Takeaways
- A new meta-analysis of data on more than 4500 patients with chronic urticaria showed a median omalizumab drug survival of 3.1 years.
- Discontinuation occurred most often after patients achieved adequate disease control.
- Discontinuation because of adverse events was uncommon.
- Autoimmune comorbidities, mainly thyroid-related, were associated with discontinuation because of lack of efficacy.
Omalizumab demonstrated a median drug survival of more than 3 years among patients with chronic urticaria (CU), with successful disease control rather than adverse events emerging as a common reason for treatment discontinuation, according to a systematic review and meta-analysis published online in JAMA Dermatology.
The analysis included 8 observational studies and 4516 patients with CU, including 3167 female patients (70.1%) and 3276 patients with chronic spontaneous urticaria (CSU). Investigators systematically searched PubMed, Embase, and Web of Science through January 20, 2026, and reconstructed time-to-event data from published Kaplan-Meier curves.
Omalizumab Drug Survival Reached a Median of 3.1 Years
Median omalizumab drug survival was 3.1 years (95% CI, 2.8 to 3.4). During 7 years of follow-up, patients remained on treatment for a mean of 3.75 years (95% CI, 3.62 to 3.87).
Long-term survival appeared higher among patients with chronic inducible urticaria, with or without concomitant CSU, compared with patients with CSU alone. Seven-year drug survival ranged from 43% to 49% in chronic inducible urticaria compared with 30% in CSU alone.
Early discontinuation occurred primarily after well-controlled disease, whereas discontinuation because of adverse events was uncommon. Autoimmune comorbidity, predominantly thyroid-related disease, was associated with greater risk of discontinuation because of lack of efficacy (HR, 2.03; 95% CI, 1.20 to 3.41). An atopic background was associated with increased discontinuation after achieving disease control.
“The results of this systematic review and meta-analysis suggest that omalizumab demonstrates long-term drug survival in CU, with discontinuation more often due to disease control than adverse events,” the authors wrote. “Autoimmune comorbidities (mainly thyroid-related) were associated with reduced drug survival, primarily due to lack of efficacy, whereas atopic comorbidities were associated with discontinuation after disease control, underscoring the need for improved endotype-driven treatment strategies.”
Source
Altayf A, et al. JAMA Dermatology. 2026. Doi:10.1001/jamadermatol.2026.2043