This systematic review evaluated clinical, laboratory, and treatment-related factors associated with progression from acute urticaria (AU) to chronic urticaria (CU), searching MEDLINE, Embase, and Web of Science through December 31, 2025.
Across 16 studies (n=52,564), progression rates ranged from 5.8% to 36.0%; no single clinical or laboratory marker — including disease severity, angioedema, IgE levels, eosinophil counts, autoantibodies, or systemic corticosteroid use — was consistently associated with progression to CU.
- High methodologic heterogeneity across studies with varying follow-up durations and outcome definitions. - Moderate to high risk of bias in included studies; higher progression rates may reflect selection bias in tertiary centers. - Qualitative synthesis only — meta-analysis was not feasible due to heterogeneity.
Do not use aggressive treatment (e.g., systemic corticosteroids) during acute urticaria solely to prevent chronicity — current evidence does not support this approach. Structured clinical follow-up remains the best tool while better prognostic markers are awaited.
Explore related topics
