Types of non sedating antihistamines
♣ Levocetirizine 10 mg vs Bilastine 80 mg p = 0.01.According to current recommendations, patients with CU who do not respond to licensed doses of NSAHs should be switched to higher doses in order to obtain a better disease control.Among those, 3 papers dealing with the treatment of patients with CSU were excluded from analysis because of their open design, 2 employing cetirizine and one that utilized ebastine .Another study by Metz et alwas also excluded because it assessed exclusively the effects of a 20 mg dose of rupatadine in patients with acquired cold urticaria whereas no comparisons with other doses of the drug were done [ summarizes the details from 8 double-blind, placebo-controlled studies included in this report.Efficacy of increased doses of nonsedating antihistamines in patients with chronic urticaria. *Fexofenadine 120 mg vs Fexofenadine 240 mg p = 0.01, ¶ Fexofenadine 120 mg vs Rupatadine 20 mg p = 0.0001, ♦ Fexofenadine 240 mg vs Rupatadine 20 mg p = 0.03.B) According to percentage of symptom-free patients.Bilastine belongs to the piperidine class of antihistamines as do loratadine, desloratadine, and fexofenadine.
It can be observed that the proportion of symptom improvement was highly variable, ranging from 3.4% to 71.6%, depending on the drug and dose.According to the International Guidelines for the management of urticaria and angioedema non-sedating, second generation antihistamines (NSAHs) are recommended for the treatment of CU .Nevertheless, a considerable proportion of patients do not respond sufficiently to NSAHs.There were not significant differences in efficacy between fexofenadine and bilastine, rupatadine and bilastine, and desloratadine and levocetirizine.
However, fexofenadine, rupatadine, and bilastine showed significantly higher efficacy than desloratadine or levocetirizine, and rupatadine had higher efficacy than fexofenadine.
Six articles included patients with CSU/CIU and other 2 studied patients with acquired cold urticaria.