Allergy & Immunology

No consistent predictors of progression from acute to chronic urticaria

This systematic review of 16 studies (52 564 patients) found AU-to-CU progression rates ranging from 5.8% to 36.0% depending on follow-up and setting. Clinical features (severity, angioedema, atopy), laboratory markers, and systemic corticosteroid use lacked consistent association with progression. Heterogeneity, short follow-up, and moderate-to-high risk of bias limited certainty of prognostic signals. Clinical implication: perform careful serial assessment and structured follow-up; avoid assuming a single early marker will stratify chronicity risk. 1

Population-level asthma exacerbations fell after respiratory biologics entered practice

In 5269 adults seen in specialty clinics (2006–2025), exacerbations rose before 2015 then showed an immediate drop of -474.1 events per 1000 patients per year after 2015. A sustained yearly decline followed (-206.5 events per 1000 patients per year), with larger gains in patients with ≥2 exacerbations and high eosinophils. Results support population-level effectiveness of biologics, particularly in high-risk phenotypes characterized by frequent exacerbations or eosinophilia. Observational interrupted-time-series design cannot prove causality and may reflect secular trends or selection into specialty care. 2

DOOR endpoint offers patient-centered benefit-risk comparison for ABSSSI trials

Investigators developed an infectious-disease DOOR for ABSSSI and retrospectively applied it to OASIS-1 and OASIS-2 comparing omadacycline versus linezolid. DOOR probabilities were near equipoise: 50.6% (95% CI, 47.4%–53.7%) and 52.1% (95% CI, 49.2%–55.0%) favoring omadacycline in the two trials. Using SF-36v2 as a tiebreaker did not materially change results, and partial-credit analyses were concordant. DOOR may aid benefit-risk interpretation in ABSSSI trials but requires prospective use and validation before regulatory reliance. 3