422 Biologic therapy: the last resort in the treatment of chronic spontaneous urticaria

Chronic spontaneous urticaria (CSU) is defined by the presence of recurrent hives, associated in over 60% cases with angioedema, lasting for more than 6 weeks, due to unknown trigger. It affects around 1% adult population and has a negative impact on patients’ quality life, interfering their daily activities work productivity. Omalizumab an anti-IgE monoclonal antibody, first biologic agent approved treatment CSU patients not responding traditional H1 antihistamines. Patients’ response omalizumab appears be related immune mechanism mast cell activation, therefore subjects IgE-mediated disease appear have faster onset improvement those IgG-mediated unique mechanisms which this IgE levels FcεR1 receptor status. In regard, we present case 35-year-old patient, who presents itchy rash, consisting hives palpebral labial angioedema. The patient many allergies NSAIDs, metals, food environmental allergens. followed numerous conventional topical systemic treatments, but without significant therapeutic success. Therefore, it was decided initiate therapy (Xolair). During 3 months post-therapy, did any urticarial episodes, increase life. debilitating, difficult-to-treat disease, human economic burden often underestimated. There considerable delay between symptoms establishment correct diagnosis. Most time, experience mental health deterioration, that can lead development anxiety depression. Thus, early diagnosis, appropriate restore patient’s self-esteem hope normal