• Posted July 18, 2025

What Are The Best Treatments For Chronic Hives?

Hives can drive a person crazy, covering parts of the body with maddeningly itchy welts.

Now, a new evidence review has identified the most effective treatments for people who suffer from chronic hives.

The injectable antibody drug omalizumab and a yet-to-be-approved pill called remibrutinib are among the most effective treatments for reducing the itch and swelling of hives, researchers reported July 15 in the Journal of Allergy and Clinical Immunology.

Another injectable antibody drug called dupilumab also showed promise in reducing hives, researchers said.

A cheaper and time-tested drug, cyclosporine, is also effective but carries a higher risk of kidney damage, high blood pressure and other side effects, researchers added.

“This first comprehensive analysis of all advanced treatment options for chronic urticaria (hives) provides a clear and evidence-based ‘menu of treatment options’ for patients and their clinicians to choose from,” senior researcher Dr. Derek Chu, an assistant professor of medicine at McMaster University in Ontario, Canada, said in a news release.

Hives occur when skin cells release histamine as part of an allergic reaction, according to Harvard Medical School. The biochemical causes tiny blood vessels to leak, and the leaking fluid forms into swollen welts.

For the review, researchers pooled data from 93 previous clinical trials involving more than 11,000 participants. The team examined more than 40 treatment options for hives, considering both how effective they are and any safety issues they might have.

Omalizumab and remibrutinib rated highest in terms of effectiveness and safety, results show.

Omalizumab is an injectable drug that blocks the action of Immunoglobulin E, an antibody that promotes allergic reactions. The pricey drug is sold under the brand name Xolair, but earlier this year the U.S. Food and Drug Administration (FDA)  approved a biosimilar form called Omlyclo developed by the drug company Celltrion.

Remibrutinib is currently under FDA review. Developed by Novartis, the pill has been shown in clinical trials to help more than half of patients with chronic hives. It works by blocking an enzyme cascade that prompts release of histamine.

The evidence review also found that the injectable drug dupilumab (Dupixent) is effective against hives. Approved in 2017, this drug works by blocking two inflammatory proteins, interleukin-4 and interleukin-13.

A much cheaper drug, cyclosporine, is effective against hives “but may be among the most harmful in increasing the frequency of any adverse events,” researchers wrote.

The findings of this study will be used to help write new international clinical guidelines for treating hives, researchers said.

More information

Harvard Medical School has more about hives.

SOURCE: McMaster University, news release, July 15, 2025