Ligelizumab is a “next generation” humanized monoclonal antibody to IgE.  It was designed to be a “better mousetrap” to treat people with severe chronic urticaria.  Chronic urticaria (recurrent hives) is fairly common, occurring in 1 case per 200 people.  In most cases it can be controlled with oral medications primarily in the form of antihistamines.

 

Many people gain control with a single H1 receptor antihistamine such as Allegra or Zyrtec.  Some patients require the addition of an H2 receptor antihistamine such as Pepcid.

 

However, the patients unable to gain control with these simple/safe medications have had to resort to oral steroids, not a good long-term strategy.  Then a few years ago, the earliest developed monoclonal antibody for IgE, Omalizumab, which has been used to treat asthma for many years, was found to be very helpful for chronic severe urticaria.  It truly has been a Godsend, and up until now it was the best resource for these severe patients.

 

Now comes Ligelizumab which seems to be even more effective.  In fact, in head to head comparison studies of Ligelizumab and Omalizumab 51% of the Ligelizumab study group had complete resolution of their hives compared to 26% of the Omalizumab group.  There was a greater frequency of injection site reactions with Ligelizumab then with Omalizumab.  Also, Ligelizumab is so new, its long-term safety is yet to be determined whereas Omalizumab having been available for many years is known to have a fairly safe track record.