New Rules for Old Hives

“We have to keep in mind that urticaria has to be treated until it's completely gone. So, absolute control of the disease.” — Dr. Herminio LimaChronic spontaneous urticaria has long been managed with the goal of complete symptom control. But for many patients, that goal remains elusive. In this episode of The Allergist, Dr. Mariam Hanna talks with dermatologist and clinical immunologist Dr. Herminio Lima about the updated urticaria guidelines—and how new treatment options are giving clinicians more ways to act, and more hope for getting patients all the way to control.On this episode:What’s new in the 2025 guideline—including additional second-line options beyond antihistaminesWhy nearly 40% of patients may need to escalate to biologicsHow remibrutinib compares to omalizumab and what its trials revealedWhat the CUPID studies say about dupilumab, especially in biologic-naive patientsKey safety signals and clinical considerations for the new treatment optionsHow to move toward full disease control—and why suboptimal outcomes are no longer acceptableComplete control is still the destination, but the path to get there is about to get a lot more flexible.Have an idea for the show or a comment, send us a text!Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions