In addition to anti-IgE antibodies, the guideline recommends anti-IL-4α antibodies and BTK inhibition

The 2026 revised edition of the international urticaria guidelines incorporates the latest findings on pathogenesis and treatment options. Chronic spontaneous urticaria (CSU) encompasses various immunological endotypes with implications for the selection of the appropriate biologic or “small molecules.” In addition to omalizumab, dupilumab—another monoclonal antibody—is available in the EU as an add-on therapy; furthermore, the oral BTK inhibitor remibrutinib has since received EMA approval—and remibrutinib was also recently approved in Switzerland.