Emerging treatments for chronic urticaria
Bettina Wedi

Introduction: Around the world, chronic hives (CU), i.e. chronic spontaneous hives (CSU) and chronic inducible hives (CINDU), is typical, lengthy-persisting and hard to handle. Still, a minumum of one-fifth isn’t sufficiently controlled by guideline-suggested treatment with H1-antihistamines and add-on therapy using the anti-IgE monoclonal antibody omalizumab.

Areas covered: Using PubMed, ClinicalTrials.gov, Congress websites, and websites from the manufacturers, this review explored the pipeline, namely anti-IgE-, anti-cytokine-, anti-receptor biologics, and small molecules, in clinical development for CU.

Expert opinion: The CU pipeline is promising. While three omalizumab biosimilars are investigated, the assumed early approval of ligelizumab will expand the secure and efficient anti-IgE approach observed with omalizumab. For other anti-IgEs like UB-221, the event is behind. Data are extremely limited to date to obviously define the function of anti-cytokine and anti-cytokine receptor biologics for example dupilumab, tezepelumab, mepolizumab, benralizumab, and CDX-0159, which only dupilumab is really investigated in phase 3. Among three selective dental BTK inhibitors, remibrutinib, rilzabrutinib, and fenebrutinib, the introduction of remibrutinib is innovative (phase 3). Because the pipeline addresses different targets, study results can give much deeper insights in to the pathomechanisms of CU. Hopefully, within the next future additional approved as well as more targeted approaches is going to be available.LOU064