Avances en urticaria cronica.

Answered on March 7, 2025

The latest developments in the treatment of chronic spontaneous urticaria (CSU) include several promising therapeutic options beyond the current standard of care. The first-line treatment remains second-generation H1-antihistamines, which can be increased up to fourfold if necessary. For patients who do not respond adequately, omalizumab, an anti-IgE monoclonal antibody, is the next step.[1-2]

Recent advances have focused on targeting specific immune pathways involved in CSU. Bruton's tyrosine kinase (BTK) inhibitors, such as remibrutinib, have shown efficacy by reducing mast cell activation. Dupilumab, which targets the interleukin-4 (IL-4) and IL-13 pathways, is also under investigation and has shown promise in clinical trials. Additionally, ligelizumab, another anti-IgE monoclonal antibody, has demonstrated significant efficacy, although a recent phase III study was discontinued due to nonsuperior clinical impact compared to omalizumab.[1-3]

Other emerging treatments include barzolvolimab, which targets the tyrosine kinase receptor Kit, and therapies targeting the Mas-related G protein-coupled receptor X2 (MRGPRX2). These novel agents offer potential for patients with refractory CSU and may modify the disease course by targeting key immune mechanisms.[1]

Overall, these developments highlight a shift towards more personalized and targeted therapies, aiming to improve outcomes for patients with difficult-to-treat CSU.[1-3] Further research and clinical trials are essential to validate these treatments and integrate them into clinical practice.

Therapies for Chronic Spontaneous Urticaria: Present and Future Developments.

Asero R, Calzari P, Vaienti S, Cugno M.

Pharmaceuticals (Basel, Switzerland). 2024;17(11):1499. doi:10.3390/ph17111499.

New Research

2.

Chronic Urticaria: Unmet Needs, Emerging Drugs, and New Perspectives on Personalised Treatment.

Zuberbier T, Ensina LF, Giménez-Arnau A, et al.

Lancet (London, England). 2024;404(10450):393-404. doi:10.1016/S0140-6736(24)00852-3.

Leading Journal

New Research

3.

Current and Future Management of Chronic Spontaneous Urticaria and Chronic Inducible Urticaria.

Do TT, Canty EA, Joshi SR.

Allergy and Asthma Proceedings. 2023;44(1):3-14. doi:10.2500/aap.2023.44.220093.

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