ACE inhibitors may interfere with omalizumab in chronic spontaneous urticaria

Abstract

The extrinsic pathway of coagulation cascade is activated in chronic spontaneous urticaria (CSU), and such activation parallels disease severity (1). D-dimer levels are elevated in cases resistant to antihistamines (2) and/or cyclosporine (3). Omalizumab is highly effective in most patients with severe, antihistamine-resistant CSU. Two cases of severe CSU in which ACE-inhibitor was associated with the loss of response to omalizumab are reported.

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