Drug Survival of Omalizumab

In this episode of the Urticaria podcast series, Prof. Torsten Zuberbier speaks with Reineke Soegiharto, PhD candidate and dermatology resident from UMC Utrecht, about the international UCARE study DRUSO-CU, which investigated the drug survival of omalizumab in chronic urticaria.

They discuss: 🔹 What does “drug survival” mean and why is it a meaningful real-world outcome measure? 🔹 How long do patients with chronic urticaria typically remain on omalizumab therapy? 🔹 Why do patients discontinue treatment — and what does this say about effectiveness and safety? 🔹 How do early treatment response and disease duration influence long-term outcomes? 🔹 What role do chronic inducible urticarias (CIndU) play in treatment duration? 🔹 Are adverse events or reimbursement issues relevant reasons for stopping omalizumab?

Based on data from more than 2,000 patients across 14 UCARE centers worldwide, the study shows that omalizumab has excellent long-term safety and effectiveness. Importantly, treatment discontinuation is most often due to well-controlled disease, not side effects or lack of efficacy. Patients with a rapid early response tend to stop treatment sooner, while those with longer disease duration or concomitant CIndU often require longer therapy. The discussion highlights the importance of early and effective disease control and showcases the value of international collaboration within the UCARE network.

Key Learnings from the Episode: Drug survival reflects effectiveness, safety, and real-world treatment decisions. About 50% of patients remain on omalizumab after 3.3 years overall. In good responders, 50% are still treated after approximately 7 years. Discontinuation is most commonly due to well-controlled disease. Adverse events do not significantly impact omalizumab drug survival. Early and strong treatment response predicts shorter overall treatment duration. Longer disease duration before treatment is associated with longer therapy needs. Patients with chronic inducible urticaria often remain on treatment longer. Seasonal and subtype differences are relevant in CIndU management. Reimbursement issues were not a major factor in treatment discontinuation. Omalizumab shows an excellent long-term safety profile. International UCARE collaboration enables meaningful real-world research.

Chapters: 00:00 Introduction to Urticaria and Research Initiatives 03:10 Understanding Drug Survival in Chronic Urticaria 06:10 Predictors of Treatment Duration with Omalizumab 08:54 The Role of Disease Duration and Response 11:33 Exploring Chronic Inducible Urticaria 14:23 The Experience of Collaborative Research in UCARE

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