Allergy & Immunology

Chronic Spontaneous Urticaria

Expert Roundtables Podcast: Defining Treatment Success in Patients With Chronic Spontaneous Urticaria

expert roundtables by Jonathan A. Bernstein, MD; Thomas B. Casale, MD; Adam Friedman, MD, FAAD

Overview

Chronic spontaneous urticaria (CSU) remains a challenging condition to diagnose and treat. Current management now emphasizes a treat-to-clearance approach, with a rapid dose escalation of nonsedating H₁ antihistamines and second-line therapy with biologics such as omalizumab or dupilumab. As our experts note in today’s podcast, these strategies are reshaping expectations for success in CSU care.

References

Bernstein JA, Schatz M, Zuberbier T. In lasting tribute: professor Marcus Maurer (1966-2024)—a visionary in allergy research and a highly respected physician. J Allergy Clin Immunol Pract. 2025;13(3):452-453. doi:10.1016/j.jaip.2025.01.025

Calzari P, Chiei Gallo A, Barei F, et al. Omalizumab for the treatment of chronic spontaneous urticaria in adults and adolescents: an eight-year real-life experience. J Clin Med. 2024;13(18):5610. doi:10.3390/jcm13185610

Friedman A, Kwatra SG, Yosipovitch G. A practical approach to diagnosing and managing chronic spontaneous urticaria. Dermatol Ther (Heidelb). 2024;14(6):1371-1387. doi:10.1007/s13555-024-01173-5

Kolkhir P, Fok JS, Kocatürk E, et al. Update on the treatment of chronic spontaneous urticaria. Drugs. 2025;85(4):475-486. doi:10.1007/s40265-025-02170-4

Kolkhir P, Laires PA, Salameh P, et al. The benefit of complete response to treatment in patients with chronic spontaneous urticaria—CURE results. J Allergy Clin Immunol Pract. 2023;11(2):610-620.e5. doi:10.1016/j.jaip.2022.11.016

Maurer M, Albuquerque M, Boursiquot JN, et al. A patient charter for chronic urticaria. Adv Ther. 2024;41(1):14-33. doi:10.1007/s12325-023-02724-6

Maurer M, Casale TB, Saini SS, et al. Dupilumab reduces urticaria activity, itch, and hives in patients with chronic spontaneous urticaria regardless of baseline serum immunoglobulin E levels. Dermatol Ther (Heidelb). 2024;14(9):2427-2441. doi:10.1007/s13555-024-01231-y

Mosnaim G, Casale TB, Holden M, Trzaskoma B, Bernstein JA. Characteristics of patients with chronic spontaneous urticaria who are late-responders to omalizumab. J Allergy Clin Immunol Pract. 2024;12(9):2537-2539. doi:10.1016/j.jaip.2024.05.043

Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/Ga²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734-766. doi:10.1111/all.15090

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Jonathan A. Bernstein, MD

Adjunct Professor of Clinical Medicine
Division of Rheumatology, Allergy and Immunology
Department of Internal Medicine
University of Cincinnati Medical Center
Partner, Advanced Allergy Services and Bernstein Clinical Research Center, LLC
Cincinnati, OH

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Thomas B. Casale, MD

Professor of Medicine and Pediatrics
Chief of Clinical and Translational Research
Division of Allergy and Immunology
University of South Florida
Tampa, FL

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Adam Friedman, MD, FAAD

Professor and Chair of Dermatology
Director, Residency, Translational Research, Hidradenitis Suppurativa, and Supportive Oncodermatology Programs
Department of Dermatology
The George Washington University School of Medicine & Health Sciences
Washington, DC