Omalizumab (Xolair) is recommended as a possible treatment for people aged 12 years and over with severe chronic spontaneous urticaria if:

  • a doctor has objectively diagnosed the condition as severe
  • the condition has not improved with standard treatment with H1‑antihistamines or leukotriene receptor antagonists
  • the drug is stopped at or before the fourth dose if the condition has not responded
  • the drug is stopped at the end of a course of treatment (6 doses) if the condition has responded, and is only restarted if the condition comes back
  • the drug is given by a secondary care specialist in dermatology, immunology or allergy.

What does this mean for me?

If you have chronic spontaneous urticaria, and your doctor thinks that omalizumab is the right treatment, you should be able to have the treatment on the NHS.

Omalizumab should be available on the NHS within 3 months of the guidance being issued.

If you are not eligible for treatment as described above but are already taking omalizumab, you should be able to continue treatment until you and your doctor decide it is the right time to stop.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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