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NICE recommends omalizumab as treatment for severe chronic spontaneous urticaria

Published: 29 June 2015
Skin diseases
Around 15% of people in the UK experience urticaria at some time in their lives

The National Institute for Health and Care Excellence (NICE) has issued guidance to the health service on omalizumab for spontaneous urticaria, informed by a report produced by SHTAC.

Urticaria, commonly referred to as nettle rash or hives, is a severe and distressing skin condition presenting as a raised, itchy rash on the skin, which may cause a burning or stinging sensation. Around 15% of people in the UK experience urticaria at some time in their lives. While symptoms may be short-lived and often resolve completely after a few months, in around 20% of cases symptoms can persist for more than 10 years. Chronic spontaneous urticaria (CSU) often has a non-specific/ unknown (idiopathic) cause, with daily or almost daily symptoms occurring for more than 6 weeks. The symptoms of CSU can have a severe impact on the quality of life of sufferers, negatively affecting sleep, daily activities, work (or school in the case of children), and social interactions.

NICE’s guidance is that omalizumab can be used as a possible treatment for people aged 12 years and over with severe chronic spontaneous urticaria, if:

  • a doctor has objectively diagnosed the condition as severe
  • the condition has not improved with standard treatment with H1 antihistamines or leukotriene receptor antagonists
  • the drug is stopped at or before the fourth dose if the condition has not responded
  • the drug is stopped at the end of a course of treatment (6 doses) if the condition has responded, and is only restarted if the condition comes back
  • the drug is given by a secondary care specialist in dermatology, immunology or allergy.

The Evidence Review Group report produced by SHTAC which informed NICE’s appraisal is available from the Health Technology Assessment programme website.

For more information on SHTAC's research on skin diseases please visit our Research page.

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