Church MK, et al. – This study entailed the exploration of bilastine, for updosing in urticaria. The data signified that the remarkable profile of bilastine, in both efficacy and safety, made it possible to present as the ideal H1–antihistamine, for updosing the daily dose fourfold in difficult–to–treat urticaria. The updosing was followed as per the EAACI/GALEN/EDF/WAO guideline, for the management of urticaria.

Methods

• An analysis was performed of the strong clinical efficacy and freedom from unwanted adverse effects, especially sedation.

Results

• Bilastine was found to be a highly effective H1-antihistamine, even when used at the basic dose of 20 mg daily.
• Its facilitated uptake after oral dosage, resulted in a rapid onset and long duration of action.
• In both wheal and flare studies and in urticaria, updosing four fold demonstrated an increased effectiveness.
• With regard to somnolence, bilastine was displayed as a substrate for P-glycoprotein, a membrane pump which prevented it from crossing the blood-brain barrier.
• As a result, bilastine was established as a practically ‘non-sedating’ H1-antihistamine.