Complete response to dupilumab in a patient with chronic spontaneous urticaria who did not tolerate omalizumab

Chronic spontaneous urticaria (CSU) is characterized by mast cell-driven wheals, angioedema, or both. Two endotypes of CSU have been identified, ie, autoallergic and autoimmune CSU. The latter comes with high disease activity as well as poor response to antihistamine and omalizumab treatment.1 Dupilumab was recently demonstrated to be effective in patients with antihistamine-resistant CSU.2 Here, we report a patient with CSU who did not tolerate or benefit from omalizumab, but showed complete response to dupilumab.