Repeated Relapse–Retreatment Cycles After Omalizumab Withdrawal in Chronic Spontaneous Urticaria: A Real-World Study

Background/Objectives: Relapse after omalizumab withdrawal is common in chronic spontaneous urticaria (CSU), but patients requiring repeated treatment re-initiation across successive withdrawal cycles remain poorly characterized. This study aimed to characterize patients with repeated relapse requiring omalizumab re-initiation and to determine whether routinely available baseline parameters could distinguish them from other patients with CSU.

Methods

This retrospective, single-center study included 46 adults with CSU who achieved disease control with standard-dose omalizumab after an initial 6-month course. Patients were evaluated during a fixed 12-month period following the first withdrawal. Repeated omalizumab re-initiation was defined as relapse requiring re-initiation within 12 weeks after withdrawal on at least two occasions. Baseline clinical and laboratory characteristics were compared between groups, and multivariable logistic regression was performed.