Abstract
Chronic spontaneous urticaria (CSU) is a complex inflammatory skin condition that significantly impacts patients' quality of life. Conventional treatments, such as antihistamines, often fail to provide adequate symptom control. The next step involves administering omalizumab, a monoclonal antibody targeting IgE, however, a subset of patients may not respond to this treatment underscoring the necessity for alternative treatment options. Remibrutinib, an oral, selective inhibitor of Bruton's tyrosine kinase (BTK), has emerged as a promising therapy in CSU. BTK is vital for the activation of mast cells and basophils. The inhibitory action of remibrutinib on BTK may help alleviate CSU symptoms by addressing mast cell-mediated inflammation. Clinical trials, including Phase II and III studies, have shown promising efficacy and a favorable safety profile for remibrutinib in treating CSU. Patients experienced rapid symptom relief, with notable improvements in the Urticaria Activity Score (UAS7) concerning both itch intensity and the severity of hives. The safety profile was also commendable, with no significant treatment-related adverse events requiring therapy cessation or posing immediate health risks to patients. These results indicate that remibrutinib may become a preferred oral treatment for patients with moderate to severe CSU who do not adequately respond to standard therapies.