**3. Optimal dosing and interval of omalizumab treatment**

In patients with allergic asthma, optimal dose of omalizumab is determined by serum total IgE levels and body weight of the patients. Unlike for allergic asthma, the FDA approved omalizumab for the management of CSU at doses independent of serum IgE levels or body weight. Based on the 3 pivotal trials, [9–11] the approved doses of omalizumab is 150 mg or 300 mg every 4 weeks. Doses lower than 150 mg did not consistently show a significant improvement in efficacy compared with placebo, and the higher dose of 300 mg dependably showed faster and more robust efficacy. Interestingly, higher doses of omalizumab at 600 mg were explored in the dose-ranging single omalizumab dose phase II MYSTIQUE trial [23, 24]. Although no significant difference in changes of UAS7 at week 4 from baseline between the omalizumab 600 mg and 300 mg groups, there was also no increase in adverse events [25–27]. Cases of patients requiring higher than approved doses, up to 600 mg, to reach complete remission have been reported [25, 27].
