Allergic diseases are immunological exaggerations causing symptoms that may interfere with life quality. Bilastine is a novel oral second-generation H1-antihistamine that is highly selective to H1 receptors and has anti-inflammatory properties. Yet, the evidence regarding the drug efficacy is inconsistent.

The present study evaluated the efficacy and safety of bilastine compared with the placebo and other active antihistamines in patients complaining of either allergic rhinitis (AR) or chronic urticaria.

The study systematically searched the Medline, Scopus, Web of Science and Cochrane databases for randomized controlled trials (RCTs) assessing the effects of bilastine on symptomatic hyperhistaminic allergic conditions. It collected data on total symptoms scores (TSS), total nasal symptom scores (TNSS), discomfort associated with these allergic conditions measured by visual analog score (VAS), and quality of life (QoL) for AR and urticaria. The study also looked for clinical global impression and safety profiles.

The study included 9 RCTs comprising 3,801 participants. It found bilastine superior to placebo in improving TSS, TNSS, VAS and QoL in AR or chronic urticaria participants. Moreover, it found bilastine comparable to active antihistamines such as cetirizine, fexofenadine and loratadine regarding mentioned outcomes. Additionally, the novel drug was found safe and tolerable, with no difference in the incidence of adverse events with a placebo.

This study shows that bilastine safely improves TSS in hyperhistaminic allergic conditions involving nasal symptoms in AR. It also decreases the discomfort associated with the disease, improving the participants′ QoL.

Source: Abdelshafy AM, Abdallah SY, Hassan AF, et al. The impact of bilastine on symptoms of allergic rhinitis and chronic urticaria: a systematic review and meta-analysis of randomized controlled trials. Am J Rhinol Allergy. 2022;36(5):684-94.