In urticaria patients, high baseline serum IgE levels, shorter illness duration, and no history of immunosuppressive drug use were related to response to Omalizumab. Factors predictive of Cyclosporine response encompassed normal baseline D-dimer levels, high baseline UAS7, and low baseline IgE levels.

The objective of a real-world study was to assess the laboratory and clinical parameters related to third-line therapy response in chronic refractory urticaria.

Analysis of the medical records of chronic refractory urticaria patients receiving Cyclosporine and Omalizumab was done. Volunteers with a minimum follow-up of 4 months were incorporated. A therapeutic response was deemed to have occurred when the Urticaria Activity Score-7 (UAS7) decreased by >90% from baseline 4 months after the start of the intervention. Examination of medical records of 1364 chronic refractory urticaria patients was done.

The inclusion criteria was satisfied by 56 individuals who received Omalizumab and 132 subjects who got Cyclosporine. In the Omalizumab group, 82.1% of patients (46/56) and 80.3% of patients (106/132) showed signs of treatment response. Lack of prior immunosuppressive drug usage, shorter disease duration, and high baseline serum Immunoglobulin E (IgE) levels were all factors that were substantially related to response to Omalizumab.

High baseline UAS7, low levels of baseline IgE, and normal baseline D-dimer levels were all indicators of Cyclosporine response. In both groups, concurrent inducible urticaria, atopy, and angioedema were linked to non-response. When compared to the Omalizumab group (19.5%), the occurrence of side effects was somewhat greater in the Cyclosporine group (28.7%).

For forecasting treatment outcomes and help predict the prognosis of chronic refractory urticaria patients, a number of clinical parameters and laboratory markers such as high baseline serum IgE levels, shorter illness duration, and no history of immunosuppressive drug use are useful.