Improving the efficiency of urticaria management by predicting antihistamine response

Published online June 4, 2025

Antihistamines are a safe and effective therapy for controlling urticaria. However, while 50% achieve clinical control with this treatment, the other half of patients require other treatments. In a recently published article in The Journal of Allergy and Clinical Immunology: In Practice, Sánchez J et al. raise a relevant research question in the clinical practice of urticaria patients: can we predict which patients achieve control of their urticaria with antihistamines and which require other therapies? Early identification of non-responders could allow prompt initiation of other therapies, reducing the time required to achieve clinical control.

In this study, the authors developed and validated a mathematical model to predict which patients would have an adequate clinical response and which would not with antihistamines. This model was developed in more than 500 urticaria patients from five countries.

As a result of this research, they identified some variables that can be easily assessed at the initial consultation and constructed a prognostic calculator with adequate clinical accuracy. Using this calculator, clinical practice can be improved by offering early management alternatives to patients with a low likelihood of clinical control with antihistamines, reducing the time these patients spend without urticaria control and reducing the disease burden. This type of tool makes urticaria management more efficient for both the patient and the physician, without generating additional resource expenditure, making it a relevant support for the management of chronic urticaria.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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