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

Treatment of chronic spontaneous urticaria (CSU) 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.1,2

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.

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.

References

1. 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.

2. 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. doi: 10.1016/j.jaci.2024.01.028. Epub 2024 Feb 29. PMID: 38431226.