Second-generation H1-antihistamines (SGAHs) remain the cornerstone of chronic spontaneous urticaria (CSU) treatment. Bilastine, a newer non-sedating SGAH, was newly introduced in India after the approval of the Drugs Controller General of India. However, there is a lack of evidence about the long-term efficacy and safety of Bilastine in Indian patients. The present study investigated the long-term efficacy and tolerability of Bilastine in patients with CSU in India.

It analyzed electronic medical records from May 1, 2019, to March 20, 2020, to identify patients of CSU who were prescribed Bilastine. It included adult patients with CSU >6 months, who had an unsatisfactory response as per Urticaria Activity Score 7 (UAS7) to previous antihistamine therapies, and who continued treatment for at least six months. The study determined Treatment effectiveness by retrospectively reviewing their UAS7 scores from their medical records and evaluating their scores at weeks 4, 8, 12, 16, 20, and 24. Also, it assessed DLQI and compared it at baseline and week 24.

The study found-

• Inclusion of Forty-nine patients in the study.
• At the end of 24 weeks, 51% of patients achieved complete treatment response, whereas 49% showed well-controlled urticaria (UAS<6).
• At 24 weeks, the mean UAS7 score was statistically significant compared to the baseline score.
• At 24 weeks, the mean score of DLQI reduced markedly from the baseline.

This study shows that in patients who had an inadequate response to commonly used antihistamines at a double dose or combined use, switching over to Bilastine can not only relieve the symptoms of CSU but also improve the quality of life of these patients.

De A, Godse K, Dhoot D, Sarda A. Real-Life Experience of Efficacy and Safety of Bilastine in the Refractory Cases of Chronic Spontaneous Urticaria and its Effect on the Quality of Life of Patients. Indian J Dermatol. 2021 Mar-Apr;66(2):159-164. Doi: 10.4103/ijd.IJD_771_20. PMID: 34188271; PMCID: PMC8208247.