PURPOSE OF REVIEW: Symptomatic management of chronic spontaneous urticaria (CSU) 
basically depends on second-generation H1 antihistamines and omalizumab. 
Omalizumab is a game changer in the management, but still there is a need for 
new targets and new biologics targeting new pathways in the treatment which will 
provide long-lasting remission, which will be given orally and which will be 
cheaper. This review will focus on new biologics that are underway of production 
or are already under use for different disorders but could be beneficial for the 
treatment of Chronic urticaria.
RECENT FINDINGS: In this review, the treatment targets are classified according 
to the cells which are involved in the pathogenesis of CSU. Those are mast 
cells/basophils, B cells, T cells and eosinophils. The treatments that are under 
clinical trials for CSU are anti-IgE treatments such as ligelizumab, molecules 
targeting intracellular signaling pathways such as spleen tyrosine kinase 
inhibitors, surface inhibitory molecules such as siglec-8, anti-IL-1s such as 
canakinumab, Bruton kinase (BTK) inhibitors such as GDC-0853 and anti-IL-5s such 
as benralizumab and mepolizumab.
SUMMARY: The ongoing clinical trials on new targets of treatment hold new hopes 
not only for a better care of the disease but also a better understanding of the 
pathomechanisms lying underneath.