Allergy & Immunology

CIndU remains heterogenous; targeted agents are emerging

Chronic inducible urticarias show marked heterogeneity leading to variable response to H1-antihistamines and omalizumab. Emerging targeted agents, including anti‑KIT biologics and BTK inhibitors, offer mechanistic options beyond conventional therapy. Refined assessment tools and biomarker research may enable patient stratification for these novel agents. Evidence is primarily review-level and calls for validated biomarkers and trials linking mechanism to treatment response. 1

Real‑world adherence to AR pharmacotherapy is suboptimal and method‑dependent

Pooled analysis of 12 studies (n=191,103) found overall adherence to intranasal corticosteroids and oral antihistamines about 43%. Self‑report consistently overestimated adherence compared with pharmacy refill data. Adherence varied by region; intranasal steroid adherence ranged 17%–61% across geographies. Heterogeneous adherence measurement limits direct comparability and benchmark setting. 2

Few progress to severe asthma, but identifiable high‑risk profiles exist

Among 99,748 adults with mild‑to‑moderate asthma after a first exacerbation, 4.1% progressed to severe asthma within five years. Independent risk factors included age 40–49, exacerbation despite medium‑dose ICS (OR 3.72), high SABA use, ≥2 infections, and eosinophils ≥0.6×10^9/L (OR 1.97). A profile combining late‑onset eosinophilia, medium‑dose ICS use, and recurrent infections had a 30.4% five‑year progression risk. Whether earlier intervention alters this trajectory is unanswered by this observational cohort. 3