Jonathan Bernstein, MD

 using dupilumab (Dupixent) therapy led to early and sustained urticaria improvements among individuals who were included in the LIBERTY-CSU CUPID Studies A and C.

These conclusions from LIBERTY-CSU CUPID Study A and Study C were presented as poster data during the 

2025 European Academy of Dermatology and Venereology (EADV) Congress

 in Paris. Jonathan A. Bernstein, MD, trial investigator and professor of clinical Medicine in the department of internal medicine at the University of Cincinnati College of Medicine, spoke on these data and their significance.

LIBERTY-CSU CUPID Findings on Dupilumab for CSU, With Jonathan Bernstein, MD

These were studies that randomized patients between the ages of 60 and 80 with a diagnosis of chronic spontaneous urticaria over eight months,” Bernstein explained. “They had to be experiencing itch and hives for at least eight weeks, despite treatment with antihistamines. This is quantified by using validated scores. We use something called the Urticaria Activity Score of seven, and it had to be greater than sixteen. They also had to have an itch severity score, which is a component of the Urticaria Activity Score, of eight or greater in the past seven days before they were randomized in the studies.”

Bernstein noted the purpose of these trials had been to assess the efficacy of dupilumab, a fully human monoclonal antibody that blocks signaling through the interleukin-4 (IL-4) and interleukin-13 (IL-13) pathways, on urticaria activity. To do this, they evaluated patients using UAS7. The investigators looked at the pooled number of patients, with 144 having been treated with dupilumab and 145 given a placebo.

“Of course, what was found, not surprisingly, is that the dupilumab treatment improved the UAS7 score from Week Three through Week Twenty-Four and [this] was statistically significant,” Bernstein said. “This was an early response, and it was a sustained improvement in hive activity over the duration of the study. Also, this study confirmed previous the pooled study data is reflective of the individual studies, which showed that it was, overall, very safe and consistent with dupilumab.”

The quotes used in this interview summary were edited for clarity.

Bernstein has reported grants from Novartis, AstraZeneca, Sanofi-Regeneron, Amgen, Roche, Allakos, Celldex, CSL Behring, Takeda/Shire, BioCryst, Pharming, Ionis, BioMarin, Intellia, Astria, Aretrea, Pharvaris, Blueprint Medicine, Cogent, Telios, Yuhan, Evoimmune, Incyte/Escient, Jasper, Eli Lilly, Allergy Therapeutics, and Genentech.

Bernstein J, et al. Dupilumab Provides Early and Sustained Improvement in Urticaria Activity in Patients with Chronic Spontaneous Urticaria: Pooled Results From LIBERTY-CSU CUPID Study A and Study C. Presented at the 2025 European Academy of Dermatology and Venereology (EADV) Congress, Sept 17-20, 2025.

Maurer M, Casale TB, Laws E, et al. Dupilumab in patients with chronic spontaneous urticaria (LIBERTY-CSU CUPID): Two randomized, double-blind, placebo-controlled, phase 3 trials. J Allergy Clin Immunol. 2024 Jul;154(1):184-194. 

Videos

In this interview at EADV, Bernstein highlights dupilumab’s impact on urticaria activity in individuals with chronic spontaneous urticaria (CSU).

Bernstein also discussed other unmet needs in the field and how his center is working to address them.

Staying Up to Date on Urticaria, Mast Cell Disorders, with Jonathan Bernstein, MD

Angioedema can be a complication with inflammatory skin conditions such as urticaria and levies a significant burden on patients. Jonathan Bernstein, MD, adjunct professor, University of Cincinnati School of Medicine and past president of the American Academy of Allergy, Asthma, and Immunology (AAAAI) gave a talk on emerging treatment approaches for angioedema in patients with urticaria at the 2025 AAAAI/World Allergy Organization Joint Congress, February 28-March 3, in San Diego, California. Bernstein also serves as Chair of the Asthma Committee for the American College of Allergy Asthma and Immunology, and is on the Board of Directors of the WAO and Interasma.

“Patients with chronic urticaria… often times don't know where to go and how to receive effective treatment. Their journey can be burdensome, especially ones who don't respond well to treatment… [There are] a lot of wasted dollars and direct and indirect costs associated with this condition. So hopefully, we can shorten the duration of diagnosis and effective therapies by getting these patients in the hands of experts,” Bernstein told 

 spoke with Bernstein to learn more about unmet needs in the field, including a need for more clinician education and patient advocacy, which he is working to improve with the We CU advocacy group his center recently launched. He also discussed other emerging inflammatory skin diseases such as mast cell disorders, which he stressed can be complex for both clinicians and patients alike.

“We're trying to educate our colleagues about neuroimmunology and about the importance of looking at these patients more holistically and not just focused on, Do they have a positive tryptase or not? But you know, we definitely are seeing a whole new type of population in our offices, in our clinics, and these people are oftentimes pushed from one doctor to the next, and it's very difficult for them and very burdensome. So hopefully we'll start to have better their future options for them as well,” Bernstein said.

Bernstein's disclosures include Inspirotec and Ineos.

Bernstein J. Emerging Treatment Approaches to Hives, Itch, and Angioedema. Presented at: 2025 AAAAI/WAO Joint Congress, February 28-March 3.

Staying Up-to-Date on Urticaria, Mast Cell Disorders, with Jonathan Bernstein, MD

 Bernstein discussed recent and upcoming research and management of angioedema in patients with urticaria.

Understanding Angioedema in Urticaria, with Jonathan Bernstein, MD

Angioedema is a complication that has a significant burden on patients with inflammatory skin conditions such as urticaria. While research is ongoing in the field to better treat angioedema, unmet needs in its management remain.

Jonathan Bernstein, MD, adjunct professor, University of Cincinnati School of Medicine and past president of the American Academy of Allergy, Asthma, and Immunology (AAAAI) is giving a talk on emerging treatment approaches for angioedema in patients with urticaria at the 2025 AAAAI/World Allergy Organization Joint Congress, February 28-March 3, in San Diego, California.

“I think that's really the biggest thing that's confronting us, is to get clinicians understand the spectrum of angioedema and to make sure that they aren't skipping steps and going from inexpensive antihistamines to extremely expensive drugs that are targeted towards hereditary angioedema,” Bernstein told 

 spoke with Bernstein to learn more about unmet needs in patients with angioedema and urticaria, including making appropriate decisions and implementing physician education to improve this. He also discussed progress in research in the space, and current research adding to the field’s understanding of the disease, including mast cells mechanisms.

“We're learning more about mast cell biology and activation, which is really important in terms of drug development. So, we'll see how everything plays out in terms of, you know, looking at these more difficult to treat patients with chronic urticaria, and how these drugs work, but I think that we're going to see a significant benefit for patients who don't respond well to antihistamines or omalizumab in responding to some of these other alternative, mechanistic, mechanistically driven therapies,” Bernstein said.

Bernstein discussed recent and upcoming research and management of angioedema in patients with urticaria.

Jonathan Bernstein, MD

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