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NICE provisionally backs antibody as add-on treatment for hives

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The National Institute for Health and Care Excellence has published draft guidance recommending omalizumab (Xolair) as an add-on treatment for severe chronic spontaneous episodes of hives.

NICE is appraising omalizumab as a treatment for adults and young people over the age of 12 with persistent Urticaria – known more commonly as hives – when antihistamines do not work.

The treatment is currently at the final appraisal determination stage of its evaluation by NICE. Until final guidance is published, NHS bodies should make decisions locally on funding the treatment.

Omalizumab, manufactured by Novartis, is taken every four weeks as an injection and would be offered as a treatment for patients who have not responded to other treatments, including antihistamine medication.

The drug is probably better known as an asthma treatment. It was finally approved by NICE for treating severe persistent allergic asthma last year, after previously being rejected in draft guidance because of question marks over its cost-effectiveness.

Omalizumab is a monoclonal antibody that targets immunoglobulin E, a kind of antibody that participates in allergic reactions.

It is available as a 150mg solution for subcutaneous injection in a pre-filled syringe. The recommended dose is 300mg – as two injections – once every four weeks for up to 24 weeks.

A dose of 300mg costs £512.30 and a 24-week course of treatment is £3,073.80 (excluding VAT).

Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, said: “We are pleased that new evidence became available which allowed us to propose recommending omalizumab as a treatment option for people with hives.

“This treatment offers those whose condition has not improved with other treatments, a further option to control their symptoms,” she said.

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