A new phase 3 analysis has shown that dupilumab significantly improves health-related quality of life (HRQoL) in omalizumab-naïve patients with chronic spontaneous urticaria (CSU) who continue to experience symptoms despite standard H1-antihistamine therapy. The findings come from LIBERTY-CSU CUPID Study A, a double-blind trial.
CSU is defined by recurrent hives lasting longer than six weeks, and many patients find that symptoms remain disruptive even after antihistamine treatment. These unresolved symptoms can lead to substantial impacts on daily life, sleep, mental well-being, and work productivity. The current analysis specifically investigated whether dupilumab, a monoclonal antibody already approved for several type 2 inflammatory conditions, could meaningfully improve these quality-of-life burdens among patients who had not previously received omalizumab.
The study included patients aged six years and older who remained symptomatic despite antihistamines. Participants were randomly assigned to receive either dupilumab 300 mg every two weeks (n=70) or placebo (n=68). HRQoL outcomes were tracked using validated measures including the Dermatology Life Quality Index (DLQI), the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and the EQ-VAS scale at weeks 12 and 24.
Dupilumab Shows Early and Sustained Benefits
By week 24, patients treated with dupilumab experienced significantly greater improvements across all major HRQoL measures compared with placebo. Dupilumab recipients showed a mean improvement of -3.2 points in DLQI scores and -8.6 points in CU-Q2oL scores, both statistically significant differences. EQ-VAS scores also improved by 6.0 points versus placebo. These improvements indicate reduced interference of CSU with daily activities, emotional well-being, sleep, and social functioning.
Importantly, a larger proportion of patients receiving dupilumab reported “no or little” impact across most individual items of the DLQI and CU-Q2oL questionnaires, signalling broad benefits across multiple life domains. Similar positive trends were already visible at week 12, suggesting early and sustained improvement.
Why Dupilumab Is a Key Option for Chronic Urticaria
The authors conclude that dupilumab meaningfully enhances quality of life for omalizumab-naïve CSU patients who remain symptomatic despite standard care. These findings highlight quality-of-life improvement as an essential and achievable goal in the management of chronic spontaneous urticaria.
Reference
Giménez-Arnau AM. Dupilumab Improves Health-Related Quality of Life in Omalizumab-Naïve Patients with Chronic Spontaneous Urticaria. Dermatol Ther. 2025. doi: 10.1007/s13555-025-01605-w.
