A summary of data held by the BSACI Registry for Immunotherapy (BRIT) for the diagnosis, and treatment of Chronic Spontaneous Urticaria (CSU) using Omalizumab (MAB)
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Michaelis L.J.
Lajeunesse M.
Villa L.P.
Achunche S.
Maslovskaya O.
Smith M.
Baigel R.
Dawson T.
Gourgey R.
Kelly M.
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2025
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Objectives: Chronic Spontaneous Urticaria (CSU) is a debilitating disease associated with poor quality of life and performance at work and school. Those not responding to high dose antihistamines should be offered Omalizumab (OMA) in keeping with NICE guidance. The BSACI registry for Immunotherapy (BRIT) records use of OMA for CSU in adults and children. Method(s): BRIT is a secure web-based registry that records patient representation, access to care, length of treatment and adverse effects. Result(s): 375 participants with CSU were recruited across 23 services. 76.0% (285) were females and 84.8% (318) adults. 86.7% (325) were white, 7.5%(28) Asian, 2.9%(11) mixed ethnic group and 0.5%(2) black. 95.4% (680) lived in England, with 88.80% (330) from outside London, and 23 (1.9%) from Devolved Nations. Practices included NHS 97.1% (364). Referral source included Primary 46.4%(174), Secondary 16.8%(63) and Tertiary 7.2%(27) care, with other 23.7%(89) and self-referral 2.4%(9) less prominent. No shared care was the norm 87.2%(327). Severity of the condition was assessed by a validated score (UAS7) in 77.2%(44) children and 93.7% (298) adults. The UAS7 before treatment was appropriately >=28 in 59.6%(34) children and 78.9%(251) adults. Initial treatment domains for children and adults varied including high and standard dose H1 and H2 antihistamines, leukotriene antagonists prednisolone or ciclosporin. Modal OMA treatment was 300mg 84%(688) at 4 week intervals 82% (670). 26.9% (219) were on treatment and 60.0% (489) had stopped or completed treatment. Conclusion(s): BRIT demonstrates nationwide engagement in Omalizumab as treatment for CSU. Future directions include improvements in use of UAS7 and protocols, enhanced representation of ethnic minority groups, and the devolved nations. Outcomes should include data collection on impact on mental health and quality of life. Highest unmet needs include difficult-to- treat endotypes, disease modification, intolerance to or unavailability of Omalizumab.
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Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology