Transcript
Expert insights: The future of CSU treatment
“We are excited to see the real-world data of these new treatments over the next 1.5 years.” Gülseren Tuncay considers how new treatments and improved understanding of CSU will help clinicians to tailor care and improve outcomes for their patients. View transcript.
Gülseren Tuncay, MD
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We are excited to see the first real-world data of these new drugs, new treatments, over the next one-and-a-half year. I'm expecting the treatment landscape of CSU to evolve significantly with availability of newer therapies.
Several key trends will likely shape clinical practise with approval and reimbursement of new drugs such as the dupilumab, remibrutinib. Now, we are likely to see a shift toward earlier initiation of targeted therapies, especially in patients who remain uncontrolled despite antihistamine or who have specific phenotypic features.
Real-world evidence also supporting their efficacy and safety will facilitate more confident earlier use, potentially reducing disease burden and improving, of course, quality of life. As our understanding of CSU phenotypes and endotypes deepens, especially with the data highlighting distinctions such as wheals plus angioedema and angioedema phenotypes, treatment strategies will become more tailored. For instance, remibrutinib may be preferred in patients with angioedema-dominant disease, while dupilumab might be more suitable for those with atopic diseases. It will be clearer to see after first results. Biomarkers and clinical features will increasingly guide therapy selection.
The growing treatment arsenal may also open the door to combination approach in highly refractory cases or step-down strategies maybe, once disease control is achieved. For example, high-dose omalizumab could be followed by a switch or combined with new therapies in partial responders, or treatment could be tapered once long-term control is established.
As a summary, we can say CSU phenotype landscape is moving toward more proactive phenotype-driven management, supported by both innovative therapies and real-world data. This will enable clinicians to intervene earlier, match treatments more precisely to patient needs, and potentially develop more flexible treatment algorithms for sustained disease control.
Gülseren Tuncay, MD
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