Rebound Pruritus and Urticaria After Discontinuation of Chronic Antihistamine Use—A Scoping Review

J. J. B.Seng, P.Oka, and N. C.Tan,  Clinical & Experimental Allergy (2026): 1–10, https://doi.org/10.1111/cea.70291.

ABSTRACT

Background

Rebound pruritus and urticaria have been increasingly reported following discontinuation of chronic antihistamines, particularly with cetirizine and levocetirizine, prompting the United States Food and Drug Administration to issue a recent safety warning for these two medications. Currently, there are significant gaps regarding the risk factors, course and optimal management of rebound pruritus and urticaria after discontinuation of chronic antihistamine use, and if this represents a class-specific adverse effect. This review aimed to map the literature related to rebound pruritus and urticaria after discontinuation of chronic antihistamine use.

Methods

A scoping review was conducted across four major literature databases (PubMed, Embase, Web of Science and Cochrane database) and grey literature (GreySource, OpenGrey, Google Scholar) from inception to December 2025. Articles describing rebound pruritus following discontinuation of chronic antihistamine use in paediatric or adult populations were included. Antihistamines evaluated included all first- and second-generation histamine-1 antagonists.

Patient-Perceived Benefits of Named-Patient Product Sublingual Immunotherapy in Allergic Rhinitis and Asthma: Primary Results From the ERAPP Real-World Cohort Study

Caimmi D, Abouelfath A, Lassalle R et al. Allergy. 2026 Mar 8. doi: 10.1111/all.70270.

ABSTRACT
Background
Named-patient product sublingual immunotherapy (NPP-SLIT) is widely used in France, yet real-world evidence on patient-perceived benefit remains limited.
Objective
To assess treatment expectations and patient-perceived benefit over 12–15 months among recent NPP-SLIT initiators using the Patient Benefit Index (PBI) and validated patient-reported outcome measures (PROMs).
Methods
ERAPP is a prospective, multicenter, observational study in children and adults with IgE-mediated respiratory allergy. Initiators (≤ 6 months on NPP-SLIT at baseline) completed digital PROMs at baseline, Month 6, and Month 12–15. The primary endpoint was the proportion with PBI ≥ 1 at Months 12–15. Secondary endpoints were changes in PROMs; exploratory analyses examined higher PBI thresholds and item-level fulfillment.
Results
Of 9439 enrolled, 4794 were initiators (950 children; 3844 adolescents/adults). At Month 12–15, PBI ≥ 1 was achieved by 83.8% of children and 84.0% of adolescents/adults.

Comparison of Respiratory Syncytial Virus (RSV)-Specific Antibody Durability in Pregnant/Postpartum Individuals and Older Adults After RSV Vaccination

Kachikis A, Frivold C, Pike M et al.  J Infect Dis. 2026 Mar 26:jiag111. doi: 10.1093/infdis/jiag111. 

Abstract

Box plots of respiratory syncytial virus (RSV) prefusion F protein
binding antibody titers (A) and neutralizing Ab titers (B), stratified by
study group and collection time point.
Abbreviation: AU, arbitrary units.

Respiratory syncytial virus (RSV) vaccination is recommended in pregnancy. Limited data exist regarding antibody (Ab) durability to inform revaccination timing. We conducted prospective cohort studies among pregnant and older adults after first RSV vaccination in 2023–2024. Longitudinal samples from 50 pregnant (36 vaccinated) and 16 vaccinated older adults were collected until 12–15 months after vaccination and tested for RSV binding and neutralizing Ab.

The importance of long-lived IgE plasma cells for protracted allergies

Robinson MJ. Trends Immunol. 2026 Mar 17:S1471-4906(26)00009-8. doi: 10.1016/j.it.2026.01.006.

Abstract

Advances in long-lived IgE plasma cell biology
revealed through fate mapping

IgE contributes to allergy, but its cellular sources are rare and hard to identify. Genetic fate mapping and single-cell sequencing approaches have now revealed that two cell populations maintain IgE: long-lived IgE plasma cells (PCs) and ‘type 2’ memory B cells. This forum piece discusses recent discoveries on long-lived IgE PCs.

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Baseline disease duration of chronic spontaneous urticaria participants in phase III clinical trials

Gupta, S., Rao, V., Xiong, G. et al. Allergy Asthma Clin Immunol (2026). https://doi.org/10.1186/s13223-026-01026-0

Abstract

Chronic spontaneous urticaria often follows a prolonged and variable course, yet baseline disease duration is inconsistently reported in clinical trials, limiting interpretation of treatment outcomes. Accordingly, this systematic review aimed to evaluate baseline disease duration and reporting practices in phase-III trials for chronic spontaneous urticaria. Of 36 trials identified, only 16 (44.4%) reported baseline disease duration (mean: 5.30 ± 1.81 years). 

Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part II-Guidelines on Oral and Ocular Treatments

Vieira RJ, Sousa-Pinto B, Bousquet J et al.  Allergy. 2026 Mar 24. doi: 10.1111/all.70305. 

Abstract

Background: Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments.

Methods: The ARIA-EAACI 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs.

Comparison of the recommendations on oral and ocular treatments
of the ARIA 2024–2025 and of the ARIA 2010/2016 guidelines.

Results: Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication.

Feasibility and efficacy of nasal rehabilitation on nasal symptoms in patients with chronic allergic rhinitis: A pilot study

Tendulkar S, Venkatesan P, Mysore S, Lakshmi R V.  J Allergy Clin Immunol Glob. 2026 Feb 17;5(3):100674. doi: 10.1016/j.jacig.2026.100674. 

Abstract

Background

Chronic allergic rhinitis (CAR) is a highly prevalent condition characterized by nasal symptoms and mouth breathing. The detrimental effects of frequent pharmacologic treatment necessitate a nonpharmacologic treatment approach for patients with CAR.

Objective

We sought to assess the feasibility, acceptability, safety, and preliminary effects of a nasal rehabilitation program in patients with CAR.

Methods

A pilot study was conducted with 35 patients who underwent a nasal rehabilitation program for 5 weeks. The feasibility of the intervention from patient and therapist perspectives, adherence to the treatment, and occurrence of adverse events was recorded posttreatment. The preliminary effects of the treatment on nasal and mouth-breathing symptoms and disease-specific quality of life were assessed at baseline and after 5 weeks of treatment.

Results

Effect of 5 weeks of nasal rehabilitation treatment. 
A, Amount of change (mean ± SD) in TNSS, NOSE, and RQLQ outcomes. 
B, Amount of change (mean ± SD) in subdomains of RQLQ outcome.

An adherence of 92.5% was observed for the treatment. The nasal rehabilitation techniques were feasible for patients and the therapist without any adverse events.

Cost-Effectiveness of Oral Immunotherapy Treatments vs No Treatment for Peanut Allergy in Children

Huang L, Lloyd M, Franz A et al. JAMA Netw Open. 2026 Mar 2;9(3):e262410. doi: 10.1001/jamanetworkopen.2026.2410. 

Key Points

Question  Are oral immunotherapy (OIT) treatments cost-effective for managing peanut allergy in children?

Findings  This economic evaluation conducted alongside a clinical trial involving 201 children found that both probiotic peanut OIT (PPOIT) and peanut OIT were cost-effective compared with no treatment when remission was the effectiveness outcome. When effectiveness was assessed using quality-adjusted life years, PPOIT offered the best value.

Meaning  These findings suggest that PPOIT and OIT present good value compared with no treatment for achieving remission.

Abstract

Importance  The first peanut oral immunotherapy (OIT) for children was approved by the US Food and Drug Administration (FDA) in 2020.