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<p>Omalizumab is commonly used at a standard dose of 300&#xa0;mg every 4 weeks for chronic spontaneous urticaria (CSU), but a subset of patients requires dose escalation. In this retrospective, single-center observational study, we evaluated 248 adults with CSU treated with omalizumab 300&#xa0;mg; 213 (85.9%) achieved a clinical response at 300&#xa0;mg, whereas 35 (14.1%) required escalation to 450&#xa0;mg to achieve a response. Clinical and laboratory parameters were compared between the non-updosed and updosed groups. Patients who required updosing had lower body mass index (BMI; 25.30 ± 3.63 vs. 27.63 ± 5.21&#xa0;kg/m², <i>p</i> = 0.004) and lower total IgE levels (81.85 [27.40–180.75] vs. 181 [65.85–385.0] IU/mL, <i>p</i> = 0.004). On ROC analysis, a total IgE cut-off of 71.15 IU/mL predicted dose escalation (<i>p</i> = 0.004) with 73.8% sensitivity and 50.0% specificity, while a BMI cut-off of 26.825&#xa0;kg/m² predicted escalation (<i>p</i> = 0.018) with 53.5% sensitivity and 77.4% specificity. In multivariable logistic regression, BMI &lt; 26.82&#xa0;kg/m² was independently associated with a higher likelihood of dose escalation (OR 4.77, 95% CI 1.48–15.39; <i>p</i> = 0.009). In this cohort, patients requiring escalation more often had lower BMI and non-elevated total IgE, with lower BMI remaining independently associated; these findings are hypothesis-generating and warrant confirmation in prospective studies.</p>

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Lower body mass index was an independent factor of omalizumab dose escalation in adult patients with chronic spontaneous urticaria

  • 期刊论文

  • 发表日期：

    2026年3月4日

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  • Kerem Balan,
  • Neslihan Akdogan,
  • Ihsan Berkay Memisoglu,
  • Metin Zeyrek,
  • Duygu Gulseren,
  • Basak Yalici Armagan,
  • Leyla Huseynova Terzi,
  • Sibel Dogan Gunaydin,
  • Sibel Ersoy Evans

摘要

Omalizumab is commonly used at a standard dose of 300 mg every 4 weeks for chronic spontaneous urticaria (CSU), but a subset of patients requires dose escalation. In this retrospective, single-center observational study, we evaluated 248 adults with CSU treated with omalizumab 300 mg; 213 (85.9%) achieved a clinical response at 300 mg, whereas 35 (14.1%) required escalation to 450 mg to achieve a response. Clinical and laboratory parameters were compared between the non-updosed and updosed groups. Patients who required updosing had lower body mass index (BMI; 25.30 ± 3.63 vs. 27.63 ± 5.21 kg/m², p = 0.004) and lower total IgE levels (81.85 [27.40–180.75] vs. 181 [65.85–385.0] IU/mL, p = 0.004). On ROC analysis, a total IgE cut-off of 71.15 IU/mL predicted dose escalation (p = 0.004) with 73.8% sensitivity and 50.0% specificity, while a BMI cut-off of 26.825 kg/m² predicted escalation (p = 0.018) with 53.5% sensitivity and 77.4% specificity. In multivariable logistic regression, BMI < 26.82 kg/m² was independently associated with a higher likelihood of dose escalation (OR 4.77, 95% CI 1.48–15.39; p = 0.009). In this cohort, patients requiring escalation more often had lower BMI and non-elevated total IgE, with lower BMI remaining independently associated; these findings are hypothesis-generating and warrant confirmation in prospective studies.