#164 - New Chronic Hives Guidelines: A Look at What's Changing

In this journal club episode, we break down the draft of the Chronic Urticaria Guidelines: 2026 AAAAI/ACAAI Joint Task Force (JTF) on Practice Parameters GRADE- and Institute of Medicine-based recommendations. We explain what counts as chronic hives, why the guideline leans on second-generation non-drowsy antihistamines, what to do when those are not enough, and what is new for both adults and kids.

At the time of recording, the draft was open for comments; it closed for comments on June 30, 2026.

What we cover in our episode about the new chronic hives guidelines

What chronic hives are: A plain-language look at the two main types, spontaneous and inducible, plus angioedema (swelling) that can come with them.

What a draft guideline is: Why the guideline is still being reviewed, and how comments can help shape it before it is final.

What's new for kids: How children fit into the guideline, and why most do well without advanced treatments.

The antihistamine shift: Why the guideline favors non-drowsy, second-generation antihistamines and moves away from older, sedating ones.

When antihistamines are not enough: If higher-dose antihistamines do not work, the recommended advanced option is to start omalizumab (Xolair) plus two newer additions: dupilumab (Dupixent) and remibrutinib (Rhapsido).

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More hive resources

Read the draft guideline and comment details (ACAAI)

Track your symptoms: Get the CU Download to access the UAS7 and the Urticaria Control Test (UCT)