Bruton's Tyrosine Kinase Inhibitors for Chronic Spontaneous Urticaria: A Systematic Review and Meta-Analysis.

Document Type

Article

Publication Title

Journal of cutaneous medicine and surgery

Abstract

Although second-generation H1 antihistamines remain the first-line treatment for chronic spontaneous urticaria (CSU), a significant proportion of patients experience inadequate symptom control, highlighting the ongoing need for more effective and targeted treatment strategies. We conducted a systematic review and meta-analysis of 5 randomized controlled trials (RCTs) comparing Bruton's tyrosine kinase (BTK) inhibitors with placebo at 4, 8, and 12 weeks in patients with CSU. We searched PubMed, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) from inception to April 2025. The primary outcomes assessed included the Weekly Urticaria Activity Score (UAS7), complete absence of pruritus and urticaria (UAS7 = 0), well-controlled CSU (UAS7 ≤ 6), and safety outcomes. Across 5 included RCTs, 1071 (71.93%) patients received BTK inhibitors. BTK inhibitors significantly increased the likelihood of achieving UAS7 = 0 at week 4 [risk ratio (RR) 5.64; 95% confidence interval (CI) 1.04-30.70;

First Page

12034754261418239

Last Page

12034754261418239

DOI

10.1177/12034754261418239

Publication Date

4-17-2026

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