Current and future management of chronic spontaneous urticaria and chronic inducible urticaria

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


Background: Chronic urticaria (CU), characterized by ≥6 weeks of intense pruritus, remains a debilitating condition for patients. New and safe treatments are needed to manage CU recalcitrant to standard therapy. Objective: A review of the current literature of standard and novel therapeutics in the management of CU was conducted. Methods: A literature search via a medical literature data base and clinical trial data base was conducted to identify treatment options for CU and current clinical trials. Results: Second-generation antihistamines, omalizumab, and cyclosporine remain the most proven therapeutic options for CU. Dupilumab, mepolizumab, benralizumab, tezepelumab, and CDX-0159 are all undergoing clinical trials for CU. Although ligelizumab demonstrated initial promising results, a phase III study was discontinued due to a nonsuperior clinical impact compared with omalizumab. Conclusion: Novel therapies are needed for the treatment of recalcitrant CU. With a deeper understanding of the pathophysiology of CU, promising therapeutics are in clinical trials for CU.

Publication types

  • Review

MeSH terms

  • Anti-Allergic Agents* / therapeutic use
  • Chronic Disease
  • Chronic Inducible Urticaria
  • Chronic Urticaria* / drug therapy
  • Clinical Trials as Topic
  • Clinical Trials, Phase III as Topic
  • Histamine H1 Antagonists, Non-Sedating* / therapeutic use
  • Humans
  • Omalizumab / therapeutic use
  • Urticaria* / diagnosis
  • Urticaria* / drug therapy


  • Anti-Allergic Agents
  • Histamine H1 Antagonists, Non-Sedating
  • Omalizumab