Abstract :
Objective: To evaluate efficacy and safety of bilastine in higher than usual doses in patients with chronic
spontaneous urticaria (CSU).
Material and Methods: Adult patients with CSU with pruritus and wheal score of more than two
were investigated for complete blood count, urine examination, blood sugar level and thyroid-stimulating
hormone level and treated with bilastine 20 mg (one tablet) before breakfast. In patients who did not show
satisfactory response, dose was increased to 40 mg (two tablets) before breakfast at the end of one week
and 80 mg (two divided doses) at the end of two weeks, if no response seen after the end of one week.
Symptoms were evaluated using urticaria activity score (UAS) and sedation score.
Results: A total of 30 patients (mean age 30.5 years; 56.67% females; baseline mean UAS 5.2) with mean
duration of CSU of 18.9 months were enrolled. Fourteen (51.85%), 10(37.04%) and 2(7.41%) patients
became symptom-free with 20,40, and 80 mg dose of bilastine respectively whereas 1(3.70%) patient not
responding to 80 mg bilastine required cyclosporine. After 1 week of treatment, 3 patients were lost to
follow up. Bilastine was well tolerated without any serious adverse events.
Conclusion: Bilastine is effective and well tolerated in higher (up to 4 times) than normal doses in the
management of chronic spontaneous urticaria.
Keyword :
Bilastine, Chronic spontaneous urticaria, Efficacy.