Progression From Acute to Chronic Urticaria: A Systematic Review.

What was studied

Hives that start suddenly are called acute urticaria. Sometimes the hives go on and last a long time. This is called chronic urticaria. The team looked for signs that show who goes on to the long-lasting form. They did a systematic review, which gathers and sums up past studies. The studies only watched people and did not test a new treatment. The search covered studies up to December 31, 2025.

What they found

The review held studies with 52 564 people in total. How many people went on to long-lasting hives varied a lot between studies. This depended on how long people were followed and how terms were defined. How severe the hives were did not give a clear pattern. Neither did swelling under the skin, allergies, or an allergic background. Blood tests, like allergy antibody levels, did not predict it reliably. Nor did white blood cell counts or inflammation scores. Using steroid drugs early did not lower the risk of long-lasting hives.

What it means for patients

The authors found no single sign that clearly predicts long-lasting hives. They say the evidence does not back strong early treatment just to prevent it. They say careful checks and planned follow-up visits remain key. New data on immune and inflammation markers may help spot people at higher risk.

Why it is not certain yet

The studies differed a lot in how they were done. Many followed people for only a short time. Many had a moderate to high risk of bias. Because of these gaps, the results were described in words, not combined. The authors call for well-planned studies across many centers. These should follow people forward in time, for longer, with shared definitions. A review can only be as good as the studies in it.

Source

Progression From Acute to Chronic Urticaria: A Systematic Review.

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