To evaluate the efficacy and safety of dupilumab in patients with chronic spontaneous urticaria (CSU) who remained symptomatic despite antihistamine therapy.
Key Findings:
Dupilumab significantly reduced itch severity (−8.64 vs −6.10) and overall urticaria activity (−15.86 vs −11.21) compared to placebo at week 24.
70% of dupilumab patients achieved at least a 5-point reduction in itch severity compared to 52% in the placebo group.
In pooled analysis, dupilumab showed greater improvements in itch severity (−9.94 vs −6.71) and urticaria activity (−19.29 vs −13.13).
Safety profiles were similar between dupilumab and placebo groups, with common adverse events including nasopharyngitis and injection-site erythema.
Interpretation:
Dupilumab demonstrates significant clinical benefits in reducing itch and urticaria activity in CSU patients unresponsive to antihistamines, with a favorable safety profile.
Limitations:
The study duration of 24 weeks limited the assessment of long-term treatment effects.
The small number of pediatric participants and limited racial and ethnic diversity may affect generalizability.
Conclusion:
The CUPID-C trial reinforces the efficacy and safety of dupilumab for CSU patients who are refractory to antihistamines, supporting its use in clinical practice.
Off-label ivarmacitinib rapidly relieved pruritus and improved skin lesions in a patient with refractory primary cutaneous amyloidosis, according to a case report.
