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Advancing Allergy Practice in CSU: From Pathophysiology to Patient-Centered Care - Episode 3

Remibrutinib Onset of Action and Safety Profile

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Shyam Joshi, MD, discusses the rapid onset of action and favorable safety profile of remibrutinib, distinguishing it among therapies for CSU.

New data on remibrutinib demonstrates the agent’s rapid onset of action in patients with chronic spontaneous urticaria (CSU). Shyam Joshi, MD, assistant professor of medicine in the Section of Allergy and Clinical Immunology at Oregon Health & Science University (OHSU) School of Medicine, discussesdiscusses data from phase 3 REMIX trials revealed that significant improvements in symptom control were observed as early as one to two weeks following initiation of therapy. This early efficacy distinguishes remibrutinib from established biologic therapies, such as omalizumab and dupilumab, which typically require longer durations to achieve comparable clinical endpoints.

The rapid mitigation of pruritus and hive activity provides clinically meaningful relief for patients who often experience prolonged morbidity prior to effective management. Early symptom resolution can improve sleep quality, daily functioning, and overall quality of life for individuals with CSU. For clinicians, the potential to offer immediate improvement is a significant advancement, particularly for those patients suffering with delayed diagnosis and limited success on previous therapies.

The most notable side effect in clinical trials was the occurrence of mild petechiae, which generally resolved without intervention and did not necessitate discontinuation of therapy. Importantly, incidence rates for infection, changes in immunoglobulin levels, and alterations in B cell function were comparable between remibrutinib and placebo groups. These data provide clinicians with confidence in prescribing remibrutinib as a safe and efficacious option within the CSU treatment landscape.

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