2f:I[703058,["/_next/static/immutable/chunks/01paypqginy0h.js","/_next/static/immutable/chunks/1thp5uf9zr3zl.js","/_next/static/immutable/chunks/18st_ghz-9_12.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/31nozh34lrzg9.js","/_next/static/immutable/chunks/1wwib9tz7-gtq.js","/_next/static/immutable/chunks/0t-245yo8v_7x.js","/_next/static/immutable/chunks/0r4zly9oj045f.js","/_next/static/immutable/chunks/18zpky__xcemv.js","/_next/static/immutable/chunks/316o2u2mp21uq.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/00pb_zlp7vf18.js"],"PaperListPageClient"] 30:Tdcf,ABSTRACT Background Many patients with chronic spontaneous urticaria (CSU) remain symptomatic despite receiving second‐generation H 1 ‐antihistamines (sgH 1 ‐AH). This data analysis from the Chronic Urticaria Registry (CURE) aimed to describe treatment patterns and identify unmet needs in real‐world practice. Methods CURE is an international, prospective registry of patients with chronic urticaria. Treatment responses were categorized as Urticaria Control Test (UCT) changes from baseline (BL) to 6‐month follow‐up (FU). Complete response was defined as UCT = 16 with a ≥ 3‐point increase. Results Data were available from 3995 adult patients with CSU at BL and 1288 at FU with evaluable UCT. After treatment escalation from BL to FU, 5.3% (no treatment to licensed‐dose sgH 1 ‐AH), 6.0% (licensed‐dose sgH 1 ‐AH to up‐dosed sgH 1 ‐AH), and 28.4% (any dose sgH 1 ‐AH to omalizumab) achieved complete response. Factors associated with a lower probability of treatment escalation at FU were UCT ≥ 12 and omalizumab treatment at BL (both p < 0.0001). About one‐third (28.6%) of patients clinically eligible for escalation at BL (UCT < 12) did not receive step‐up treatment (18.0%) or were even stepped down (10.6%) and remained poorly controlled at FU. Factors associated with lack of escalation in this group included younger age ( p = 0.014), shorter disease duration ( p = 0.071), presence of wheals and angioedema ( p = 0.002), better quality of life ( p = 0.001), and treatment with up‐dosed sgH 1 ‐AH ( p = 0.031). Conclusion Appropriate treatment escalation improves CSU control, although only about a quarter of patients achieve a complete response, indicating the need for novel treatments. Many patients with poorly controlled CSU do not receive guideline‐recommended treatment escalation and remain symptomatic on their current treatments, which deserves further attention. 31:T6c3,Chronic spontaneous urticaria (CSU) is a mast cell-driven disease associated with systemic inflammation and altered immune responses. Haptoglobin (HP), an acute-phase glycoprotein, exhibits antioxidative and immunomodulatory properties, while zonulin, the precursor of HP-2, regulates epithelial barrier integrity. We investigated the clinical relevance of serum HP and zonulin in CSU and their association with treatment outcomes. Serum HP and zonulin levels were measured by ELISA in 124 CSU patients and 57 healthy controls (HCs). In 62 CSU patients, follow-up samples were obtained after 3 months of treatment. Clinical outcomes included the urticaria activity score over 7 days (UAS7) and the urticaria control test (UCT). Serum HP levels were significantly higher in CSU patients than in HCs (median 1145.1 vs. 839.2 μg/mL, p < 0.001), whereas zonulin levels did not differ. HP correlated positively, but weakly, with the white blood cell count, C3 and C-reactive protein (all rho ≈ 0.2), and negatively with disease duration and eosinophil percentage. Zonulin correlated negatively with UCT scores but not with HP. After treatment, HP decreased significantly (p < 0.001), with greater reductions in patients showing a ≥ 12-point improvement on the UAS7. Baseline HP was higher in patients who achieved complete control (UCT = 16) than others (p = 0.017). ROC analysis identified baseline HP ≥ 1249 μg/mL as an optimal cutoff, confirmed as an independent predictor of complete control (odds ratio = 4.23, p = 0.029). Serum HP is elevated in CSU patients, decreases with treatment, and independently predicts complete urticaria control. HP may serve as a potentially prognostic biomarker for CSU.32:Ta9f,ABSTRACT Background Chronic spontaneous urticaria (CSU) is a mast cell‐driven disease associated with systemic inflammation and altered immune responses. Haptoglobin (HP), an acute‐phase glycoprotein, exhibits antioxidative and immunomodulatory properties, while zonulin, the precursor of HP‐2, regulates epithelial barrier integrity. We investigated the clinical relevance of serum HP and zonulin in CSU and their association with treatment outcomes. Methods Serum HP and zonulin levels were measured by ELISA in 124 CSU patients and 57 healthy controls (HCs). In 62 CSU patients, follow‐up samples were obtained after 3 months of treatment. Clinical outcomes included the urticaria activity score over 7 days (UAS7) and the urticaria control test (UCT). Results Serum HP levels were significantly higher in CSU patients than in HCs (median 1145.1 vs. 839.2 μg/mL, p < 0.001), whereas zonulin levels did not differ. HP correlated positively, but weakly, with the white blood cell count, C3 and C‐reactive protein (all rho ≈ 0.2), and negatively with disease duration and eosinophil percentage. Zonulin correlated negatively with UCT scores but not with HP. After treatment, HP decreased significantly ( p < 0.001), with greater reductions in patients showing a ≥ 12‐point improvement on the UAS7. Baseline HP was higher in patients who achieved complete control (UCT = 16) than others ( p = 0.017). ROC analysis identified baseline HP ≥ 1249 μg/mL as an optimal cutoff, confirmed as an independent predictor of complete control (odds ratio = 4.23, p = 0.029). Conclusion Serum HP is elevated in CSU patients, decreases with treatment, and independently predicts complete urticaria control. HP may serve as a potentially prognostic biomarker for CSU. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Prospective Cohort in Allergy: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed Allergy papers on Prospective Cohort (study design). Clinician-written summaries and practical action steps. 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After treatment escalation from BL to FU, 5.3% (no treatment to licensed-dose sgH","abstract":"Many patients with chronic spontaneous urticaria (CSU) remain symptomatic despite receiving second-generation H\nCURE is an international, prospective registry of patients with chronic urticaria. Treatment responses were categorized as Urticaria Control Test (UCT) changes from baseline (BL) to 6-month follow-up (FU). Complete response was defined as UCT = 16 with a ≥ 3-point increase.\nData were available from 3995 adult patients with CSU at BL and 1288 at FU with evaluable UCT. After treatment escalation from BL to FU, 5.3% (no treatment to licensed-dose sgH\nAppropriate treatment escalation improves CSU control, although only about a quarter of patients achieve a complete response, indicating the need for novel treatments. Many patients with poorly controlled CSU do not receive guideline-recommended treatment escalation and remain symptomatic on their current treatments, which deserves further attention.","keywords":["antihistamine","chronic spontaneous urticaria","chronic urticaria registry (CURE)","real‐world practice","treatment escalation"],"pubmed_id":"41532642","conclusions":"Appropriate treatment escalation improves CSU control, although only about a quarter of patients achieve a complete response, indicating the need for novel treatments. Many patients with poorly controlled CSU do not receive guideline-recommended treatment escalation and remain symptomatic on their current treatments, which deserves further attention.","publication_date":"2026-01-14T00:00:00"},"crossref":{"DOI":"10.1111/all.70199","URL":"https://doi.org/10.1111/all.70199","ISSN":["0105-4538","1398-9995"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.70199","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/all.70199","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Unmet Needs in Treatment Escalation for Chronic Spontaneous Urticaria: Findings From the\n CURE\n Registry"],"author":[{"given":"Pavel","family":"Kolkhir","sequence":"first","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität Zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}]},{"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität Zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"},{"name":"School of Medicine Lebanese American University Byblos Lebanon"},{"name":"Institut National de Santé Publique D'épidémiologie Clinique et de Toxicologie‐Liban (INSPECT‐LB) Beirut Lebanon"},{"name":"Department of Primary Care and Population Health University of Nicosia Medical School Nicosia Cyprus"}]},{"given":"Magdalena","family":"Zajac","sequence":"additional","affiliation":[{"name":"European Center for Diagnosis and Treatment of Urticaria Medical University of Silesia Katowice Poland"}]},{"given":"Alicja","family":"Kasperska‐Zajac","sequence":"additional","affiliation":[{"name":"European Center for Diagnosis and Treatment of Urticaria Medical University of Silesia Katowice Poland"}]},{"given":"Ana","family":"Giménez‐Arnau","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research Institute, Universitat Pompeu Fabra Barcelona Spain"}]},{"given":"Maria","family":"Puertolas","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research Institute, Universitat Pompeu Fabra Barcelona Spain"}]},{"given":"Hanna","family":"Bonnekoh","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität Zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}]},{"given":"Carolina","family":"Vera Ayala","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität Zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}]},{"given":"Michael","family":"Makris","sequence":"additional","affiliation":[{"name":"Allergy Unit “D. Kalogeromitros”, 2nd Department, Dermatology and Venereology, National and Kapodistrian University of Athens, “Attikon” University Hospital Athens Greece"}]},{"given":"Eleni","family":"Chatzidimitriou","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, 1st Department of Dermatology‐Venereology, Andreas Sygros Hospital Athens Greece"}]},{"given":"Stamatios","family":"Gregoriou","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, 1st Department of Dermatology‐Venereology, Andreas Sygros Hospital Athens Greece"}]},{"given":"Kanokvalai","family":"Kulthanan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}]},{"given":"Andrea","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital Carl Gustav Carus, Technical University Dresden Dresden Germany"}]},{"given":"Mojca","family":"Bizjak‐Suran","sequence":"additional","affiliation":[{"name":"Division of Allergy University Clinic of Respiratory and Allergic Diseases Golnik Golnik Slovenia"},{"name":"Faculty of Medicine University of Ljubljana Ljubljana Slovenia"},{"name":"Faculty of Maribor University of Maribor Maribor Slovenia"}]},{"given":"Daria","family":"Fomina","sequence":"additional","affiliation":[{"name":"Moscow City Research and Practical Center of Allergy and Immunology, State Budgetary Healthcare Institution “Moscow Clinical Science and Research Hospital 52 of Moscow Healthcare Department” Moscow Russian Federation"},{"name":"Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University Moscow Russian Federation"},{"name":"Department of Pulmonology Astana Medical University Astana Kazakhstan"}]},{"given":"Alexis","family":"Bocquet","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Immunology CHU Grenobles Alpes Grenoble France"}]},{"given":"Joachim","family":"Dissemond","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venerology and Allergology University of Essen Essen Germany"}]},{"given":"Mohamed","family":"Abuzakouk","sequence":"additional","affiliation":[{"name":"Allergy & Immunology Department Cleveland Clinic Abu Dhabi Abu Dhabi UAE"}]},{"given":"Tara","family":"Raftery","sequence":"additional","affiliation":[{"name":"Novartis Ireland Ltd. 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Complete response was defined as UCT=16 with a ≥3‑point increase.","key_result":"Data were available for 3995 patients at baseline and 1288 with evaluable 6‑month UCT; after treatment escalation, only about one quarter achieved a complete response. Many poorly controlled patients did not receive guideline-recommended escalation and remained symptomatic.","limitations":"Only 1288/3995 had evaluable 6‑month UCT, which may limit generalizability. Registry design without randomization limits causal inference about treatment escalation effects.","practice_takeaway":"Escalate therapy per guidelines when CSU remains uncontrolled and track UCT; expect improved control but complete response in only about one in four at 6 months. Many patients remain on ineffective regimens without escalation, so reassess and adjust therapy rather than continue the status quo."}},{"doi":"10.1002/clt2.70148","pmid":"41498512","title":"Serum Haptoglobin as a Predictor of Treatment Response in Patients With Chronic Spontaneous Urticaria","journal_title":"Clinical and Translational Allergy","journal_issn":"2045-7022","published_at":"2026-01-07T00:00:00.000Z","url":"https://doi.org/10.1002/clt2.70148","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1002/clt2.70148","days":"30","issn":"2045-7022","rank":"3","field":"Clinical Medicine","score":"14","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1002/clt2.70148","title":"Serum Haptoglobin as a Predictor of Treatment Response in Patients With Chronic Spontaneous Urticaria.","journal":"Clinical and translational allergy","methods":"","results":"Serum HP levels were significantly higher in CSU patients than in HCs (median 1145.1 vs. 839.2 μg/mL, p < 0.001), whereas zonulin levels did not differ. HP correlated positively, but weakly, with the white blood cell count, C3 and C-reactive protein (all rho ≈ 0.2), and negatively with disease duration and eosinophil percentage. Zonulin correlated negatively with UCT scores but not with HP. After treatment, HP decreased significantly (p < 0.001), with greater reductions in patients showing a ≥ 12-point improvement on the UAS7. Baseline HP was higher in patients who achieved complete control (UCT = 16) than others (p = 0.017). ROC analysis identified baseline HP ≥ 1249 μg/mL as an optimal cutoff, confirmed as an independent predictor of complete control (odds ratio = 4.23, p = 0.029).","abstract":"$31","keywords":["chronic spontaneous urticaria","complete control","haptoglobin","zonulin"],"pubmed_id":"41498512","conclusions":"Serum HP is elevated in CSU patients, decreases with treatment, and independently predicts complete urticaria control. 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Urticaria","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"sample_size","value":"n=181","value_numeric":181},{"paper_doi":"10.1002/clt2.70148","tag_type":"study_design","value":"Prospective Cohort","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"warning","value":"ROC details (e.g., AUC, sensitivity/specificity) and confidence intervals for the odds ratio were not provided.","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"warning","value":"Study design mixes a case–control comparison with a 3‑month follow‑up cohort; classification as a prospective cohort is approximate.","value_numeric":null},{"paper_doi":"10.1002/clt2.70148","tag_type":"warning","value":"Treatment type(s) and setting were not reported, which may affect generalizability of the predictive cutoff.","value_numeric":null}],"summaries":{"what_studied":"Measured serum haptoglobin (HP) and zonulin by ELISA in 124 patients with chronic spontaneous urticaria (CSU) and 57 healthy controls; 62 CSU patients had repeat testing after 3 months of treatment. Clinical outcomes were UAS7 and UCT, with ROC analysis of baseline HP for predicting complete control (UCT=16).","key_result":"Baseline HP was higher in CSU than controls (median 1145.1 vs 839.2 μg/mL, p<0.001) and fell after treatment (p<0.001), with larger drops in patients improving ≥12 UAS7 points. An HP cutoff ≥1249 μg/mL independently predicted complete control at 3 months (odds ratio 4.23, p=0.029).","limitations":"Only 62/124 patients had 3‑month follow‑up, and the observation window was short. The HP cutoff (≥1249 μg/mL) was derived and tested in the same cohort with no external validation reported. Specific treatment regimens were not described, limiting applicability across therapies.","practice_takeaway":"In CSU, baseline serum HP ≥1249 μg/mL was linked to higher odds of complete control at 3 months, and HP levels declined with clinical improvement. Consider HP as a prognostic and monitoring biomarker alongside UAS7/UCT, pending validation and clarification across treatment types."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"category","value":"Allergy"},{"tag_type":"study_design","value":"Prospective Cohort"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Allergy","href":"/hub/Allergy"},{"name":"Prospective Cohort"}],"hrefConfig":{"basePath":"/hub/Allergy/papers","webViewQueryParams":{"hub_ctx":"category_tag","hub_category":"Allergy","hub_tag_type":"study_design","hub_tag_value":"Prospective Cohort"}}}]]

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