Would you still consider omalizumab for CSU with angioedema in a patient with Factor V Leiden deficiency?   

Heterozygosity of this genetic mutation increases the lifetime risk of thrombosis by about 7-fold, while homozygosity (which is rare) increases the risk by approximately 20-fold. Despite the increase in the risk of VTE, there is no clinical evidence that heterozygosity of factor V Leiden increases o...

To directly answer your question, this would be a definite shared decision-making conversation to have with the patient. Assuming the CSU is not part of a significant MCAS picture, this is a quality-of-life condition vs a potential life-threatening complication (ATE, VTE). Before even having the con...