1. 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;77:734–766.

2. Gonçalo M, Gimenéz-Arnau A, Al-Ahmad M, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol 2021;184:226–236.

3. Fricke J, Ávila G, Keller T, et al. Prevalence of chronic urticaria in children and adults across the globe: systematic review with meta-analysis. Allergy 2020;75:423–432.

4. Ye YM, Koh YI, Choi JH, et al. The burden of symptomatic patients with chronic spontaneous urticaria: a real-world study in Korea. Korean J Intern Med 2022;37:1050–1060.

5. Balp MM, Halliday AC, Severin T, et al. Clinical remission of chronic spontaneous urticaria (CSU): a targeted literature review. Dermatol Ther (Heidelb) 2022;12:15–27.

6. Kolkhir P, Bonnekoh H, Metz M, Maurer M. Chronic spontaneous urticaria: a review. JAMA 2024;332:1464–1477.

7. Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M. Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2017;31:964–971.

8. Ye YM, Yoon J, Woo SD, et al. Clustering the clinical course of chronic urticaria using a longitudinal database: effects on urticaria remission. Allergy Asthma Immunol Res 2021;13:390–403.

9. Kocatürk E, Salameh P, Asero R, et al. Sex matters in CSU: women face greater burden and poorer urticaria control, especially in midlife-CURE insights. J Eur Acad Dermatol Venereol 2026;40:67–78.

10. Choi JH, Lee DH, Song WJ, et al. The KAAACI/KDA evidence-based practice guidelines for chronic spontaneous urticaria in Korean adults and children: part 2. management of H1-antihistamine-refractory chronic urticaria. Allergy Asthma Immunol Res 2020;12:750–770.

11. Kim MA, Choi JH, Shin YS, Park HS, Ye YM, KAAACI Work Group on Urticaria/Angioedema/Anaphylaxis. Efficacy of second-line treatments in chronic urticaria refractory to standard dose antihistamines. Allergy Asthma Immunol Res 2023;15:496–511.

12. Maurer M, Kolkhir P, Pereira MP, et al. Disease modification in chronic spontaneous urticaria. Allergy 2024;79:2396–2413.

13. Metz M, Giménez-Arnau A, Hide M, et al. Remibrutinib in chronic spontaneous urticaria. N Engl J Med 2025;392:984–994.

14. Kaplan A, Lebwohl M, Giménez-Arnau AM, Hide M, Armstrong AW, Maurer M. Chronic spontaneous urticaria: focus on pathophysiology to unlock treatment advances. Allergy 2023;78:389–401.

15. Asero R, Ferrer M, Kocaturk E, Maurer M. Chronic spontaneous urticaria: the role and relevance of autoreactivity, autoimmunity, and autoallergy. J Allergy Clin Immunol Pract 2023;11:2302–2308.

16. Gimenez-Arnau AM, Salman A, Podder I. Biomarkers to predict therapeutic response in chronic spontaneous urticaria: a review. Eur J Dermatol 2024;34:3–12.

17. Kolkhir P, Altrichter S, Asero R, et al. Autoimmune diseases are linked to type IIb autoimmune chronic spontaneous urti caria. Allergy Asthma Immunol Res 2021;13:545–559.

18. Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med 1993;328:1599–1604.

19. Ulambayar B, Chen YH, Ban GY, et al. Detection of circulating IgG autoantibody to FcɛRIα in sera from chronic spontaneous urticaria patients. J Microbiol Immunol Infect 2020;53:141–147.

20. Choi BY, Yang EM, Jung HW, et al. Anti-heat shock protein 10 IgG in chronic spontaneous urticaria: relation with miRNA-101–5p and platelet-activating factor. Allergy 2023;78:3166–3177.

21. Kolkhir P, Giménez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primers 2022;8:61.

22. Ali H. Regulation of human mast cell and basophil function by anaphylatoxins C3a and C5a. Immunol Lett 2010;128:36–45.

23. Yang S, Chen L, Zhang H, et al. Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria. J Neuroinflammation 2025;22:75.

24. Subramanian H, Gupta K, Ali H. Roles of Mas-related G protein-coupled receptor X2 on mast cell-mediated host defense, pseudoallergic drug reactions, and chronic inflammatory diseases. J Allergy Clin Immunol 2016;138:700–710.

25. Sandig H, Bulfone-Paus S. TLR signaling in mast cells: common and unique features. Front Immunol 2012;3:185.

26. Agier J, Pastwińska J, Brzezińska-Błaszczyk E. An overview of mast cell pattern recognition receptors. Inflamm Res 2018;67:737–746.

27. Oliver ET, Saini SS. Chronic spontaneous urticaria: etiology and pathogenesis. Immunol Allergy Clin North Am 2024;44:421–438.

28. Toubi E, Vadasz Z. The emerging role of IL-17 in the immune-pathogenesis of chronic spontaneous urticaria. Immunotargets Ther 2020;9:217–223.

29. Kim HY, Jeong D, Kim JH, Chung DH. Innate type-2 cytokines: from immune regulation to therapeutic targets. Immune Netw 2024;24:e6.

30. Altrichter S, Frischbutter S, Fok JS, et al. The role of eosinophils in chronic spontaneous urticaria. J Allergy Clin Immunol 2020;145:1510–1516.

31. Saini SS. Urticaria and basophils. Allergol Int 2023;72:369–374.

32. Xiang YK, Hu M, Elieh-Ali-Komi D, Salman A, Smola A, Ko catürk E. Biomarkers in chronic spontaneous urticaria: are we ready for its use in clinical practice? Curr Treat Options Allergy 2025;12:15.

33. Ye YM, Lee HY, Moon DH, Park KW, Park SM. Distinct cytokine profiles in chronic spontaneous urticaria refractory to H1-antihistamines compared to healthy controls. Clin Exp Allergy 2025;55:1147–1149.

34. Auyeung P, Mittag D, Hodgkin PD, Harrison LC. Autoreactive T cells in chronic spontaneous urticaria target the IgE Fc receptor Iα subunit. J Allergy Clin Immunol 2016;138:761–768e4.

35. Palomares O, Elewaut D, Irving PM, Jaumont X, Tassinari P. Regulatory T cells and immunoglobulin E: a new therapeutic link for autoimmunity? Allergy 2022;77:3293–3308.

36. Choi BY, Ye YM. Role of platelet-activating factor in the pathogenesis of chronic spontaneous urticaria. Int J Mol Sci 2024;25:12143.

37. Mostmans Y, De Smedt K, Richert B, Elieh Ali Komi D, Maurer M, Michel O. Markers for the involvement of endothelial cells and the coagulation system in chronic urticaria: a systematic review. Allergy 2021;76:2998–3016.

38. Cugno M, Borghi A, Garcovich S, Marzano AV. Coagulation and skin autoimmunity. Front Immunol 2019;10:1407.

39. Kaplan AP. Chronic spontaneous urticaria: pathogenesis and treatment considerations. Allergy Asthma Immunol Res 2017;9:477–482.

40. Song WJ, Choi M, Lee DH, et al. The KAAACI/KDA Evidence-based practice guidelines for chronic spontaneous urticaria in Korean adults and children: Part 1. Definition, methodology and first-line management. Allergy Asthma Immunol Res 2020;12:563–578.

41. Rayner DG, Liu M, Chu AWL, et al. Leukotriene receptor antagonists as add-on therapy to antihistamines for urticaria: systematic review and meta-analysis of randomized clinical trials. J Allergy Clin Immunol 2024;154:996–1007.

42. Ulambayar B, Yang EM, Cha HY, Shin YS, Park HS, Ye YM. Increased platelet activating factor levels in chronic spontaneous urticaria predicts refractoriness to antihistamine treatment: an observational study. Clin Transl Allergy 2019;9:33.

43. Hide M, Suzuki T, Tanaka A, Aoki H. Efficacy and safety of rupatadine in Japanese adult and adolescent patients with chronic spontaneous urticaria: a double-blind, randomized, multicenter, placebo-controlled clinical trial. Allergol Int 2019;68:59–67.

44. Gimenez-Arnau A, Pujol RM, Ianosi S, et al. Rupatadine in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled multicentre study. Allergy 2007;62:539–546.

45. Prasertcharoensuk A, Chongpison Y, Thantiworasit P, et al. Combining dipyridamole and cilostazol with up-dosing antihistamines improves outcomes in chronic spontaneous urticaria with high D-dimer levels: a randomized controlled trial. Exp Dermatol 2024;33:e15168.

46. Oliver ET, Chichester K, Devine K, et al. Effects of an oral CRTh2 antagonist (AZD1981) on eosinophil activity and symptoms in chronic spontaneous urticaria. Int Arch Allergy Immunol 2019;179:21–30.

47. Chang TW, Chen C, Lin CJ, Metz M, Church MK, Maurer M. The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria. J Allergy Clin Immunol 2015;135:337–342.

48. Prussin C, Griffith DT, Boesel KM, Lin H, Foster B, Casale TB. Omalizumab treatment downregulates dendritic cell FcepsilonRI expression. J Allergy Clin Immunol 2003;112:1147–1154.

49. Metz M, Staubach P, Bauer A, et al. Clinical efficacy of omalizumab in chronic spontaneous urticaria is associated with a reduction of FcɛRI-positive cells in the skin. Theranostics 2017;7:1266–1276.

50. Chan MA, Gigliotti NM, Dotson AL, Rosenwasser LJ. Omalizumab may decrease IgE synthesis by targeting membrane IgE+ human B cells. Clin Transl Allergy 2013;3:29.

51. Busse W, Spector S, Rosén K, Wang Y, Alpan O. High eosinophil count: a potential biomarker for assessing successful omalizumab treatment effects. J Allergy Clin Immunol 2013;132:485–486e11.

52. Holgate S, Smith N, Massanari M, Jimenez P. Effects of omalizumab on markers of inflammation in patients with allergic asthma. Allergy 2009;64:1728–1736.

53. Ye YM. The use of omalizumab in chronic urticaria: available data and future aspects of anti-IgE treatment. In: Papakonstantinou E, ed. Urticaria - Diagnosis and Management. London: IntechOpen, 2021.

54. Gasser P, Tarchevskaya SS, Guntern P, et al. The mechanistic and functional profile of the therapeutic anti-IgE antibody ligelizumab differs from omalizumab. Nat Commun 2020;11:165.

55. Maurer M, Ensina LF, Gimenez-Arnau AM, et al. Efficacy and safety of ligelizumab in adults and adolescents with chronic spontaneous urticaria: results of two phase 3 randomised controlled trials. Lancet 2024;403:147–159.

56. Weber ANR, Bittner Z, Liu X, Dang TM, Radsak MP, Brunner C. Bruton’s tyrosine kinase: an emerging key player in innate immunity. Front Immunol 2017;8:1454.

57. Kaplan A, Ledford D, Ashby M, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. J Allergy Clin Immunol 2013;132:101–109.

58. Hide M, Park HS, Igarashi A, et al. Efficacy and safety of omalizumab in Japanese and Korean patients with refractory chronic spontaneous urticaria. J Dermatol Sci 2017;87:70–78.

59. Zhang W, Cao X, Liu L. Efficacy and safety of Omalizumab in the treatment of CSU: a meta-analysis of a randomized controlled trial. Arch Dermatol Res 2025;317:785.

60. Tharp MD, Bernstein JA, Kavati A, et al. Benefits and harms of omalizumab treatment in adolescent and adult patients with chronic idiopathic (spontaneous) urticaria: a meta-analysis of “real-world” evidence. JAMA Dermatol 2019;155:29–38.

61. Kaplan A, Ferrer M, Bernstein JA, et al. Timing and duration of omalizumab response in patients with chronic idiopathic/spontaneous urticaria. J Allergy Clin Immunol 2016;137:474–481.

62. Lee HY, Jeon HS, Jang JH, et al. Predicting responses to omalizumab in antihistamine-refractory chronic urticaria: a real-world longitudinal study. J Allergy Clin Immunol Glob 2024;3:100245.

63. Giménez Arnau AM, Valero Santiago A, Bartra Tomás J, et al. Therapeutic strategy according to differences in response to omalizumab in patients with chronic spontaneous urticaria. J Investig Allergol Clin Immunol 2019;29:338–348.

64. Casale TB, Win PH, Bernstein JA, et al. Omalizumab response in patients with chronic idiopathic urticaria: Insights from the XTEND-CIU study. J Am Acad Dermatol 2018;78:793–795.

65. Saini SS, Maurer M, Dytyatkovska Y, et al. CT-P39 compared with reference omalizumab in chronic spontaneous urticaria: results from a double-blind, randomized, active-controlled, phase 3 study. Allergy 2025;80:2167–2177.

66. Zubiaga-Fernandez L, Testera-Montes A, Rondon C, et al. Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria. Clin Exp Allergy 2024;54:402–411.

67. Maurer M, Kolkhir P, Moñino-Romero S, Metz M. The crucial role of IgE as a predictor of treatment response to omalizumab in chronic spontaneous urticaria. J Allergy Clin Immunol Pract 2023;11:2390–2391.

68. Cain WV, Jandarov RA, Priya M, Rao M, Bernstein JA. Utility of serum biomarkers in real-world practice for predicting response to omalizumab therapy in patients with chronic spontaneous urticaria. J Allergy Clin Immunol Glob 2024;4:100386.

69. Agache I, Rocha C, Pereira A, et al. Efficacy and safety of treatment with omalizumab for chronic spontaneous urticaria: a systematic review for the EAACI Biologicals Guidelines. Allergy 2021;76:59–70.

70. An SB, Yang BG, Jang G, et al. Combined IgE neutralization and Bifidobacterium longum supplementation reduces the allergic response in models of food allergy. Nat Commun 2022;13:5669.

71. Ye YM, Park JW, Kim SH, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of YH35324, a novel long-acting high-affinity IgETrap-Fc protein in subjects with atopy: results from the first-in-human study. Int Immunopharmacol 2024;130:111706.

72. Ryu MS, Yang EM, Ye YM, et al. Therapeutic efficacy of YH35324 on FcɛRIα-mediated mast cell/basophil activation. Allergy Asthma Immunol Res 2025;17:181–195.

73. Metz M, Sussman G, Gagnon R, et al. Fenebrutinib in H1 antihistamine-refractory chronic spontaneous urticaria: a randomized phase 2 trial. Nat Med 2021;27:1961–1969.

74. Carvallo A, Sánchez-Fernández S, Morales-Palacios MP. Fenebrutinib and BTK inhibition: unveiling a new target for the treatment of chronic spontaneous urticaria. Allergy 2023;78:603–605.

75. Jain V, Giménez-Arnau A, Hayama K, et al. Remibrutinib demonstrates favorable safety profile and sustained efficacy in chronic spontaneous urticaria over 52 weeks. J Allergy Clin Immunol 2024;153:479–486e4.

76. Palumbo M, Sussman G, Gogate S, et al. No clinically meaningful impact of remibrutinib on immunoglobulin levels or infections in chronic spontaneous urticaria. Ann Allergy Asthma Immunol 2024;133(6 Suppl):S98–S99.

77. Maurer M, Gimenez-Arnau A, Ferrucci S, et al. Efficacy and safety of rilzabrutinib in patients with chronic spontaneous urticaria: 12-week results from the RILECSU phase 2 dose-ranging study. J Allergy Clin Immunol 2024;153(2 Suppl):AB373.

78. Giménez-Arnau A, Ferrucci S, Ben-Shoshan M, et al. Rilzabrutinib in antihistamine-refractory chronic spontaneous urticaria: the RILECSU phase 2 randomized clinical trial. JAMA Dermatol 2025;161:679–687.

79. Serhat Inaloz H, Ozturk S, Akcali C, Kirtak N, Tarakcioglu M. Low-dose and short-term cyclosporine treatment in patients with chronic idiopathic urticaria: a clinical and immunological evaluation. J Dermatol 2008;35:276–282.

80. Stellato C, de Paulis A, Ciccarelli A, et al. Anti-inflammatory effect of cyclosporin A on human skin mast cells. J Invest Dermatol 1992;98:800–804.

81. Marsland AM, Soundararajan S, Joseph K, Kaplan AP. Effects of calcineurin inhibitors on an in vitro assay for chronic urticaria. Clin Exp Allergy 2005;35:554–559.

82. Kulthanan K, Chaweekulrat P, Komoltri C, et al. Cyclosporine for chronic spontaneous urticaria: a meta-analysis and systematic review. J Allergy Clin Immunol Pract 2018;6:586–599.

83. Boubouka CD, Charissi C, Kouimintzis D, Kalogeromitros D, Stavropoulos PG, Katsarou A. Treatment of autoimmune urticaria with low-dose cyclosporin A: a one-year follow-up. Acta Derm Venereol 2011;91:50–54.

84. Santiago L, Ferreira B, Ramos L, Gonçalo M. IgE levels are negatively correlated with clinical response to ciclosporin in chronic spontaneous urticaria. Br J Dermatol 2019;180:199–200.

85. Kay AB, Clark P, Maurer M, Ying S. Elevations in T-helper-2-initiating cytokines (interleukin-33, interleukin-25 and thymic stromal lymphopoietin) in lesional skin from chronic spontaneous (‘idiopathic’) urticaria. Br J Dermatol 2015;172:1294–1302.

86. Maurer M, Casale TB, Saini SS, et al. Dupilumab in patients with chronic spontaneous urticaria (LIBERTY-CSU CUPID): two randomized, double-blind, placebo-controlled, phase 3 trials. J Allergy Clin Immunol 2024;154:184–194.

87. Manti S, Giallongo A, Papale M, Parisi GF, Leonardi S. Monoclonal antibodies in treating chronic spontaneous urticaria: new drugs for an old disease. J Clin Med 2022;11:4453.

88. Karstarli Bakay OS, Kacar N. Combined treatment with omalizumab and secukinumab in a patient with chronic spontaneous urticaria and psoriasis. Dermatol Ther 2022;35:e15638.

89. Altrichter S, Giménez-Arnau AM, Bernstein JA, et al. Benralizumab does not elicit therapeutic effect in patients with chronic spontaneous urticaria: results from the phase IIb multinational randomized double-blind placebo-controlled ARROYO trial. Br J Dermatol 2024;191:187–199.

90. McLaren J, Chon Y, Gorski KS, et al. Tezepelumab for the treatment of chronic spontaneous urticaria: results of the phase 2b INCEPTION study. J Allergy Clin Immunol 2025;155:1945–1956.

91. Maurer M, Metz M, Anderson J, et al. Anti-KIT barzolvolimab for chronic spontaneous urticaria. Allergy 2025;80:2178–2186.

92. Maurer M, Kobielusz-Gembala I, Mitha E, et al. Barzolvolimab significantly decreases chronic spontaneous urticaria disease activity and is well tolerated: top line results from a phase 2 trial. J Allergy Clin Immunol 2024;153(2 Suppl):AB366.

93. Maurer M, Metz M, Kobielusz-Gembala I, et al. Barzolvolimab improves urticaria control and quality of life in patients with chronic spontaneous urticaria: 52-week data. J Allergy Clin Immunol 2025;155(2 Suppl):AB431.