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\begin{document}

\title{Characterization of Omalizumab Updosing Patterns and Predictive Factors
in Chronic Spontaneous Urticaria : A Prospective Multicentric
Observational Study.}



\author[1]{Guillaume PIERRARD}%
\author[2]{Claire  Bernier }%
\author[2]{AURELIE DU-THANH}%
\author[2]{Corina BARA}%
\author[2]{Angele Soria}%
\author[2]{Florence Castelain}%
\author[2]{Isabelle Boccon-Gibod}%
\author[2]{Florence Hacard}%
\author[2]{Juliette DELAUNAY}%
\author[2]{Laurence De Montjoye}%
\author[1]{Delphine STAUMONT-SALLE}%
\author[1]{Frédéric Dezoteux}%
\affil[1]{Centre Hospitalier Universitaire de Lille Service de Dermatologie}%
\affil[2]{Societe Francaise des Lasers en Dermatologie}%


\vspace{-1em}



  
  \date{May 28, 2024}


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\begin{abstract}
\textbf{Background:} Limited information is available on the use of
omalizumab (OMA) updosing since its introduction as a second-line
therapy in chronic spontaneous urticaria (CSU) in 2014. Practical
guidelines from health authorities are lacking, and the specific
characteristics of patients requiring higher doses remain unknown. Our
objectives were to characterize the patterns of OMA updosing (defined as
changes in dose and/or injection intervals), to identify the predictive
factors associated with updosing, and to improve CSU management.
\textbf{Methods:} We conducted a prospective, multicentric, real-life,
observational study, including patients diagnosed with CSU and starting
OMA. The data were collected at 0, 3, 6 and 9 months. The primary
endpoint was the frequency of OMA updosing at 3 months. The secondary
endpoints included an analysis of updosed patients' profile, and an
assessment of OMA efficacy and safety. \textbf{Results:} We included 153
patients. Twenty percent of patients at M3 were updosed, and 27\% in
total during the 9-month follow-up. Practitioners mainly chose to
increase the frequency of injections (66\%). At baseline, the updosed
patients were more likely, to have inducible urticaria (50\% vs. 33\%,
p=0.046), more severe CSU (UCT 3 vs. 4, p\textless{}0.001; DLQI 14 vs.
11, p=0.040), a lower lymphocyte count (1894 vs. 2100, p=0.026) and IgE
below 70 UI/mL (65\% vs. 45\%, p=0.039). The side effects of OMA were
not more frequent after updosing. \textbf{Conclusion:} One in five
patient underwent updosing within just three months. OMA updosing is
frequent in particular in cases of severe disease, inducible urticaria
and low IgE blood levels.%
\end{abstract}%



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