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Chronic Urticaria – Unmet Need – Unmet Need – Chronic Urticaria (US/EU)

Treatment of CSU and CIndU is dominated by oral medications, including approved therapies such as first- and second-generation antihistamines and a range of off-label options (e.g., immunosuppressants and other systemic agents). However, several of these drug classes are associated with safety and tolerability concerns, and many patients continue to experience inadequate symptom control. Novartis / Roche’s Xolair and Sanofi / Regeneron’s Dupixent are currently the only biologics approved for CSU in the United States and Europe, following Dupixent’s approvals in both regions in 2025. The first targeted oral therapy, Novartis’s Rhapsido, also received FDA approval in 2025 and EC approval in 2026. Clinical development of additional biologic and oral targeted therapies is ongoing; however, with limited approved biologic options, several unmet needs in chronic urticaria remain unaddressed, and the attributes that will meaningfully differentiate emerging therapies are still evolving.

Questions answered

  • With few targeted therapies available, what unmet needs remain in the treatment of chronic urticaria?
  • Which clinical trial endpoints and nonclinical attributes are key influencers of dermatologists’ and allergists’ prescribing decisions, and which have limited impact? What are areas of hidden opportunity?
  • How do Xolair and Dupixent perform on key treatment drivers and goals? How does their performance compare with that of frequently prescribed conventional therapies, including immunosuppressants and antihistamines?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European dermatologists and allergists for a hypothetical new chronic urticaria drug?

Product description

Unmet Need offers insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities, enabling you to:

  • Evaluate clinical and nonclinical product attributes that influence treatment decisions through physicians’ weightings and analysis of stated vs. derived importance.
  • Pinpoint areas of high unmet need by assessing current drug performance against key attributes and treatment drivers.
  • Analyze market scenarios for different target product profiles using the TPP Simulator.

Key feature

The Target Product Profile (TPP) Simulator tool allows for customizable market simulations based on conjoint analysis that depicts how physicians make decisions based on actual behavior rather than opinion. Compare up to seven TPPs across multiple disease-specific attributes and price points to gauge which variables influence prescribing behavior.

Geography: United States, France, Germany, United Kingdom

Primary research: Survey of 32 U.S. allergists, 30 U.S. dermatologists, 15 European allergists, and 18 European dermatologists conducted in February 2026.

62 U.S. and 33 European dermatologists and allergists

Key drugs covered: Xolair, Dupixent, Rhapsido, barzolvolimab, antihistamines, montelukast

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