Chronic spontaneous urticaria (CSU) is one of the most common skin diseases and leads to a significant decrease in the quality of life of patients. In some cases, in the presence of angioedema of certain localizations, this disease can lead to life-threatening conditions. Patients whose CSU is not controlled by fourfold doses of non-sedating antihistamines require genetically engineered biological therapy (GEBT) with omalizumab. Wherein, it is not always possible to achieve complete control of CSU using standard doses of this drug. Current therapeutic strategies allow achieving a complete response to therapy by escalating doses of omalizumab. This article presents the clinical experience of successful personalized selection of GIBT in patients with severe CSU, refractory to standard treatment.

Keywords: efficacy of therapy, chronic spontaneous urticaria, omalizumab, clinical case