Effect of bilastine on chronic spontaneous urticaria refractory to other antihistamines

Abstract

Bilastine, a nonsedating second-generation H 1-antihistamine, has been widely utilized for urticaria in Japan based on the high-quality evidence provided by the excellent studies. 1,2 A previous randomized trial for perennial allergic rhinitis revealed bilastine is more effective than fexofenadine, 3 speculating its therapeutic potential for chronic spontaneous urticaria refractory to other antihistamines including fexofenadine. Here, for a prospective study, bilastine 20 mg/d was admin-istrated for 18 patients (7 males and 11 females), who visited Shinsaibashi Inui Dermatology Clinic from March in 2017 to June in 2018, with chronic spontaneous urticaria refractory to usual dose of other antihistamines for more than two weeks based on the fact that they did not notice frequent change of wheals. The age of patients ranged from 23 to 62 years (mean age: 37 years). Mean disease duration was 10.8 months. Efficacy is graded by frequent change of wheals noticeable to the patients as follows: no apparent change, no effect; decreased, good; no appearance, excellent. The effect was estimated at 2 and 4 weeks after starting administration of bilastine and the endpoint of treatment. The institutional ethical committee approved this study. As results, bilastine showed excellent effect for 13 patients (72.2%), good effect for two patients This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.