Biohacking chronic urticaria: Unlocking the potential of autologous serum therapy

Objectives: Chronic spontaneous urticaria (CSU) affects patients quality of life and psychological well being, necessitating efficient, cost effective treatments that provide sustained relief and reduce pill burden. We aimed to evaluate the effectiveness of adding autologous serum therapy (AST) to standard therapy in uncontrolled CSU by assessing changes in the urticaria activity score (UAS7), urticaria control test (UCT), dermatology life quality index (DLQI), and pill burden index (PBI), while monitoring potential adverse effects. Materials and Methods: This single-centre, open-label, quasi-experimental trial included 50 adult CSU participants randomised into two groups. Group A received daily Tab levocetirizine with weekly AST injections (2 ml fresh serum) for 9 weeks; Group B received Tab levocetirizine only. Antihistamine dosing was individualised, with reduction and escalation permitted based on clinical response to evaluate treatment response and pill burden. Baseline clinical examination, investigations, scoring (UAS7, UCT, DLQI, PBI) along with autologous serum skin test (ASST) was done. Scores were reassessed at weeks 4, 8 and 14. The statistical analysis was done using SPSS analytical software version 26. Results: Group A showed a rapid and sustained reduction in disease activity, with UAS7 significantly improving by week 4 ( p = 0.004) and persisting post-therapy ( p <0.001). UCT scores indicated better disease control by week 14 ( p = 0.059). DLQI improvement was highly significant throughout ( p <0.001). A significant reduction in antihistamine pill burden was observed ( p = 0.011). AST was well tolerated, with no serious adverse effects. Conclusion: AST offers to be a cost-effective adjuvant in CSU that affects quality of life by improving disease control and reducing pill burden.