{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:49:07Z","timestamp":1793638147827,"version":"4.5.1"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"abstract":"<jats:p>\n                    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\u2019s tyrosine kinase (BTK) inhibitors with placebo at 4, 8, and 12\u2009weeks 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\u2009=\u20090), well-controlled CSU (UAS7\u2009\u2264\u20096), and safety outcomes. Across 5 included RCTs, 1071 (71.93%) patients received BTK inhibitors. BTK inhibitors significantly increased the likelihood of achieving UAS7\u2009=\u20090 at week 4 [risk ratio (RR) 5.64; 95% confidence interval (CI) 1.04-30.70;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.05], week 8 (RR 3.78; 95% CI 2.48-5.76;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.00001), and week 12 (RR 2.68; 95% CI 1.28-5.62;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.02). Consistent findings were observed for UAS7\u2009\u2264\u20096 at week 4 (RR 4.30; 95% CI 3.06-6.03;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.00001), week 8 (RR 2.60; 95% CI 2.02-3.33;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.00001), and week 12 (RR 2.05; 95% CI 1.68-2.50;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.00001). Neither the incidence of adverse events (AEs; RR 1.06; 95% CI 0.84-1.33;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.47), nor serious AEs (RR 1.17; 95% CI 0.34-4.02;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.71) was significantly different between groups. BTK inhibitors offer a valuable, safe, and effective treatment option for CSU, particularly in cases that are refractory to second-generation H1 antihistamines.\n                  <\/jats:p>","DOI":"10.1177\/12034754261418239","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T04:58:40Z","timestamp":1776488320000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Bruton\u2019s Tyrosine Kinase Inhibitors for Chronic Spontaneous Urticaria: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-9305","authenticated-orcid":false,"given":"Martin","family":"Cevallos-Cueva","sequence":"first","affiliation":[{"name":"School of Medicine, Universidad Central del Ecuador, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7918-0107","authenticated-orcid":false,"given":"Laura","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0099-8627","authenticated-orcid":false,"given":"Guilherme","family":"Kuceki","sequence":"additional","affiliation":[{"name":"Dermatology Department, Ohio Health, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5582-7535","authenticated-orcid":false,"given":"Chinenye","family":"Onejeme","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8998-4519","authenticated-orcid":false,"given":"Cristina","family":"Sicorschi Gutu","sequence":"additional","affiliation":[{"name":"Medgate AG, Allschwil, Switzerland"},{"name":"University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1481-5166","authenticated-orcid":false,"given":"Daniela L.","family":"Mendoza-Mill\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-6730","authenticated-orcid":false,"given":"Esteban","family":"Fernandez-Faith","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Pediatrics, Nationwide Children\u2019s Hospital and The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/all.13397"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2017.9.6.477"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215372"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-018-0779-z"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2025.0733"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.08.027"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01537-w"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2408792"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","unstructured":"Sterne JAC Savovi\u0107 J Page MJ et al. 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