Evaluation of Pharmacologic Treatments for H1 Antihistamine–Refractory Chronic Spontaneous Urticaria: A Systematic Review and Network Meta-analysis

Network meta-analysis (23 RCTs; n=2480) found the biologic agents ligelizumab, (72 or 240 mg; large beneficial effect) and omalizumab (300 or 600 mg; moderate beneficial effect), appeared to be effective treatments for H1 antihistamine–refractory chronic spontaneous urticaria.

SPS commentary:

The standardized mean differences for change in urticaria symptoms compared to placebo were −1.05 (95% CI, −1.37 to −0.73) for ligelizumab, 72 mg; −1.07 (95% CI, −1.39 to −0.75) for ligelizumab, 240 mg; −0.77 (95% CI, −0.91 to −0.63) for omalizumab, 300 mg; and −0.59 (95% CI, −1.10 to −0.08) for omalizumab, 600 mg.

Ligelizumab, humanised anti-IgE monoclonal antibody that belongs to the IgG1/κ isotype subclass, is currently in phase III clinical trials and was granted breakthrough therapy designation in US in Jan 2021.

JAMA Dermatology