Chronic Idiopathic Urticaria is a form of chronic hives where “chronic” means that the symptoms of hives and itching last continuously for more than six weeks. The term “idiopathic” describes, on the other hand, the fact the chronic hives appear without any apparent cause unlike e.g. hives due to allergy to foods or medications. Recently last year in March FDA has approved Omalizumab made by biopharmaceutical company Genentech/Novartis under brand name Xolair. This medication has been approved by FDA for years before for the treatment of allergic asthma, specifically moderate to severe asthma where other therapy is insufficient. Xolair/Omalizumab has been shown in multiple clinical studies to be extremely efficient in management and treatment of chronic hives.

Symptoms of CIU

Chronic urticaria can have a sudden or a gradual onset. The main symptoms of CIU include:

• Spots of small or large areas of red swollen skin commonly called hives
• Severe localized or generalized itching
• The hives can sometimes also burn or be tender
• This condition can sometimes be incapacitating and lead to disability

The management of chronic urticarial/CIU is rather difficult because the causes remain unknown and the medication used to control the itching called antihistamines may cause drowsiness and often may not be sufficient to control the symptoms. Xolair is the very first new medication in more than a decade which was approved by the FDA for the treatment of CIU. The Xolair is currently approved for patients with CIU of 12 years and older but may be, in the future, be approved for even lower age range. While Xolair when used for allergic asthma the dose needs to be calculated based on several parameters, for CIU it is always administered at 300 mg per injection once in 28 days. Xolair is very effective and most patients get relief of their hives and itching within day or two after the first injection but sometimes it may take a little longer.

What is Xolair and how it should be used?

It is a medicine which is given through injection and basically prescribed in two cases

• In case of Asthma triggered by some allergic reaction, which through blood or skin test,.
• CIU that means chronic hives without any reason, and H1- antihistamine treatment is not working.

Xolair should be used under the prescription and care of the doctor. It should be administered in a hospital or in a setting in a healthcare institution. The injections of Xolair should be given subcutaneously i.e. under the skin once every two or four weeks. Patients should follow all the recommendations of the doctor and they should not stop taking hive’s or asthma medication on their own. It can take some time to see some results after taking Xolair.