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The study is sponsored by the University Hospital of Besancon under the coordination of Dr. Julie Castagna from the Department of Dermatology and Allergology. Approximately ten percent of patients with severe chronic urticaria remain refractory to standard or optimized biologic therapy, and this observational multicenter retrospective project aims to thoroughly evaluate these challenging cases. By analyzing a target population of seventy adult participants across French hospitals, the research focuses on identifying specific clinical and biological traits, outlining risk factors associated with non-response to high-dose treatment regimens, and documenting the alternative therapeutic strategies that follow treatment failure. Data collection is structured retrospectively to cover the period from January 2020 through the end of December 2026, leveraging existing medical records without impo
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