Dupilumab, a new addition to the armamentarium for the management of chronic spontaneous urticaria: A narrative review

Chronic urticaria (CU) is a globally prevalent mast cell-driven skin disorder. Non-sedating second-generation antihistamines (nsAHs) are recommended as the first-line therapy in patients with CU and according to the guideline, non-responders to the standard dose can be given higher doses up to 4 times the standard dose. Omalizumab, an anti-immunoglobulin E antibody, is recommended for those who do not respond to higher doses of nsAH. Despite the presence of many treatment options and guidelines for their use, many patients still do not achieve adequate relief of symptoms from CU. Dupilumab, a monoclonal antibody, has been available in the market for a long time. It recently received approval from the U.S. Food and Drug Administration for the treatment of chronic spontaneous urticarial (CSU). In this review, we discussed the pharmacology, mechanism of action, and adverse effects of dupilumab in CSU.