Bilastine: a new H1‐antihistamine with an optimal profile for updosing in urticaria

  title={Bilastine: a new H1‐antihistamine with an optimal profile for updosing in urticaria},
  author={Martin K. Church and Luis Labeaga},
  journal={Journal of the European Academy of Dermatology and Venereology},
  • M. ChurchL. Labeaga
  • Published 1 September 2017
  • Medicine, Biology
  • Journal of the European Academy of Dermatology and Venereology
This review set out to examine published papers detailing the efficacy of bilastine in skin models and urticaria to assess whether it meets the optimal profile for updosing in urticaria, that is, strong clinical efficacy and freedom from unwanted side effects, particularly sedation. Bilastine is a highly effective H1‐antihistamine even when used at the basic dose of 20 mg daily. Its facilitated uptake after oral dosage gives it a rapid onset and long duration of action. In both wheal and flare… 

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All H1 antihistamines have an excellent safety profile with no evidence of cardiotoxicity even when updosed up to four times their standard licensed dose, provided that the prescribers carefully consider and rule out potential risk factors for cardiot toxicity.

The effectiveness of bilastine and fexofenadine updosing in the management of chronic spontaneous urticaria

Updosing of bilastine provided relief from urticaria symptoms, improved quality of life and less sedation compared to fexofenadine in the majority of the patients without compromising somnolence or safety.

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  • Medicine
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Bilastine, a second generation H1-antihistamine, offers significant benefits over most antihistamines including once daily dosage, significant efficacy in relieving symptom, minimal risk of drug to drug interactions and adverse events.

Effect of bilastine on chronic spontaneous urticaria refractory to levocetrizine: Real world experience in India

Bilastine was an effective H1 antihistamine in relieving the symptoms of difficult to treat CSU patients, refractory to other H1Antihistamine therapy in 4 weeks, and Weller et al concluded.

Efficacy of Bilastine in the Management of Urticaria- A Retrospective Study

Bilastine (20 mg OD), a new generation non-sedating H1-antihistamine, was highly effective in treating urticaria when given in combination with other second-generation antihistamines.

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Bilastine relieved pruritus associated with urticaria and other skin diseases, with a very good safety profile.

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This study aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria in APAC.

Efficacy and Safety of Non-brain Penetrating H1-Antihistamines for the Treatment of Allergic Diseases.

Recent topics on the pharmacodynamics and pharmacokinetics of AHs are introduced and recommendations for the use of nbpAHs as first-line treatment options for allergic diseases are made.



Safety and efficacy of bilastine: a new H1-antihistamine for the treatment of allergic rhinoconjunctivitis and urticaria

  • M. Church
  • Medicine
    Expert opinion on drug safety
  • 2011
Bilastine has high selectivity for H1-receptors, is rapidly and effectively absorbed, undergoes negligible metabolism and is a substrate for P-glycoprotein, which limits its passage across the blood–brain barrier.

H1-Antihistamine Up-Dosing in Chronic Spontaneous Urticaria: Patients' Perspective of Effectiveness and Side Effects – A Retrospective Survey Study

This survey supports the urticaria guidelines recommendations that the first line treatment for chronic spontaneous urticarial should be second generation rather than first generation H1-antihistamines and that, if standard dosing is not effective, the dosage should be increased up to four-fold.

One‐year safety and efficacy study of bilastine treatment in Japanese patients with chronic spontaneous urticaria or pruritus associated with skin diseases

Long‐term treatment with bilastine 20 mg once daily for 52 weeks is safe and well tolerated in Japanese patients with CSU or pruritus associated with skin diseases.

Establishing the place in therapy of bilastine in the treatment of allergic rhinitis according to ARIA: evidence review

Whether bilastine meets the criteria defined in the European Academy of Allergy and Clinical Immunology (EAACI)/ARIA proposals for oral H1-antihistamines for medications used in the treatment of allergic rhinitis is examined.

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It was found that updosing antihistamine updosing significantly improved control of pruritus but not weal number, however, the relative weakness of the studies and the significant heterogeneity among them made it difficult to reach a final conclusion.

EAACI/GA2LEN/EDF/WAO Guideline:Management of Urticaria

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Comparative efficacy of bilastine, desloratadine and rupatadine in the suppression of wheal and flare response induced by intradermal histamine in healthy volunteers

Bilastine 20’mg induced significantly greater inhibition of the W&F response compared with desloratadine 5 mg and rupatadines 10  mg throughout the 24 hour study period, and had the fastest onset of action.

Up-dosing with bilastine results in improved effectiveness in cold contact urticaria

The effects of a standard 20 mg dose and up‐dosing to 40 and 80 mg of bilastine in reducing the symptoms of CCU and inflammatory mediator release following cold challenge are assessed.

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