Personalization of CSU Care With Advanced Therapies

Jason Hawkes, MD, MS, a board-certified dermatologist and associate professor of Dermatology at the University of California Davis, predicts that the management of CSU—and other inflammatory skin conditions—will increasingly incorporate precision medicine principles, powered by the expansion of targeted drug options. He posits that as more data emerge, clinicians will be able to identify disease subsets and tailor interventions based on differential responses to therapies targeting specific pathogenic mechanisms.

While the classic stepwise approach (escalating from antihistamines to targeted therapies) will likely persist for reasons of efficiency and stewardship, the growing variety of advanced treatments will permit greater flexibility and customization, particularly for patients with unique clinical characteristics or comorbidities. Hawkes stresses that this trend is visible in conditions such as psoriasis, eczema, and hidradenitis suppurativa, as well as CSU.

He also highlights the importance of ongoing research into new drug classes, such as C-kit inhibitors, and the real-world adaptation of step-up and step-down approaches based on patient response and tolerability. Hawkes concludes that the future of CSU therapy lies in weaving evidence-based pathways with the nuanced understanding of patient subtypes and evolving mechanistic insights.