A 67-year-old white female with a 3-year history of recurrent, twice-weekly angioedemas of the lips, tongue and larynx. The clinical response of the angioedemas to the intake of antihistamines (AH) of doses up to three times higher than that normally recommended was not sufficient. Thus, glococorticosteroids (GCS) on a weekly basis were often necessary to control the symptoms. Omalizumab 150 mg was administered subcutaneously in 4-week intervals. After the first injection of omalizumab, facial swellings improved markedly. Treatment with AH and GCS were discontinued after 8 weeks. Omalizumab was paused after the fourth injection. Eleven weeks after stopping therapy, facial angioedemas reoccurred (Fig. ). Omalizumab 150 mg was resumed and the angioedema disappeared after 1 week. The patient stayed symptom-free. The interval between injections was stretched to every 2 months and the patient stayed symptom-free with only intermittent discrete eyelid swellings.
A 27-year-old white female suffering for 8 months from weekly recurrent angioedema of the lips and periorbital region without pruritus. No trigger factors were noticed. Since swelling episodes were not controllable with AH and GCS, doses of 300 mg s.c. of omalizumab were initiated at intervals of every 4 weeks. After the second injection no further angioedema episodes occurred.