**7. Omalizumab treatment for angioedema**

In X-ACT (Xolair Effects on Angioedema in Chronic Spontaneous Urticaria Treatment) study, a phase III, randomized, double-blind study involving selectively CSU patients with angioedema and wheals, omalizumab was superior to placebo in improving CU-Q2oL scores and reduction in angioedema-burdened days by three times during the 28-week of treatment [14, 43]. Angioedema was a prevalent symptom in patients with CSU in the three pivotal phase 3 studies of omalizumab and occurred in 44–53% of patients at baseline [9–11]. Treatment with 300 mg of omalizumab was efficacious in reducing patient-reported angioedema in patients with CIU/CSU who were symptomatic despite a variety of treatments [44]. Urgert et al. evaluated systematically the efficacy of omalizumab in CSU patients accompanying angioedema using 5 studies [21]. They provided high quality evidence of that the proportion of angioedema-free days were higher in the omalizumab group compared with placebo as well as use of rescue medications from baseline was significantly reduced in the omalizumab 300 mg group.
