ArticleClinical, cosmetic and investigational dermatology2022
A Comparative, Three-Arm, Randomized Clinical Trial to Evaluate the Effectiveness and Tolerability of Bilastine vs Fexofenadine vs Levocetirizine at the Standard Dose and Bilastine vs Fexofenadine at Higher Than the Standard Dose (Up-Dosing) vs Levocetirizine and Hydroxyzine (in Combination) in Patients with Chronic Spontaneous Urticaria.
Article in Clinical, cosmetic and investigational dermatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed, 1 citations in OpenAlex.
- Chronic Spontaneous Urticaria in the Era of Targeted Therapy: From Pathogenic Mechanisms to Precision Medicine.Pharmaceutics · 2026Review
- Montelukast and Bilastine Combination Therapy in Allergic Rhinitis: A Narrative Review of Evidence.Cureus · 2026Review
- Effectiveness, Safety, and Tolerability of Bilastine Up-Dosing in Chronic Spontaneous Urticaria Uncontrolled with Licensed Doses of Other Second-Generation Antihistamines-An Institution-Based, Open-Label, Single-Group Longitudinal Trial.Indian dermatology online journal · 2026Article
- Dermatologists' knowledge, attitudes, and practices regarding omalizumab therapy for chronic urticaria.Archives of dermatological research · 2025Article
- Clinical and quality of life improvement after bilastine treatment among patients with autoimmune chronic spontaneous urticaria.PloS one · 2025Article
- Therapies for Chronic Spontaneous Urticaria: Present and Future Developments.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Bilastine Reimagined: A Comprehensive Exploration of Pruritus Management With a Novel Antihistamine.Cureus · 2024Review
- Advances in clinical application of HZhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Review
- Evaluation of Bilastine's Efficacy and Safety in Treating Chronic Idiopathic Urticaria in Iraqi Patients.Medical journal of the Islamic Republic of Iran · 2024Article
- Diagnosis and Management of Urticaria in Indian Settings: Skin Allergy Research Society's Guideline-2022.Indian journal of dermatologyArticle
- Real-World Indian Experience of Switchover to Bilastine 40 mg/day in CSU Patient Refractory to Other Antihistamines at Double Dose.Indian journal of dermatologyArticle
- A Prospective Randomized Non-Blinded Study of Safety and Efficacy of Bilastine Up-Dosing (40 mg) Versus Combination of Bilastine 20 mg With Levocetirizine 5 mg in the Treatment of Chronic Spontaneous Urticaria.Indian journal of dermatologyArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThough second-generation antihistamines (SGAH) are first-line drugs in chronic spontaneous urticaria (CSU), 50% of patients do not respond to them. In such patients, guidelines recommend either up-dosing of SGAH or combination of different antihistamines. However, the studies comparing these treatment regimens are limited.
methodsIn this comparative, three-arm study, CSU patients were randomized to receive standard dose of either bilastine, fexofenadine, or levocetirizine for 2 weeks. After 2 weeks of treatment, non-responders received double dose of either bilastine or fexofenadine, while hydroxyzine 25 mg once daily was added in the levocetirizine group. Patients were primarily evaluated for improvement in CSU, quality of life, and somnolence.
resultsA total of 110 patients with CSU were recruited. At the end of 4 weeks, 33/39, 26/35, and 22/36 patients in the bilastine, fexofenadine, and levocetirizine groups showed improvement in urticaria symptoms. At week 2, there was no statistical difference in urticaria activity score (UAS7) improvement between any of the groups; however, at week 4, there was a statistical difference between the bilastine and levocetirizine groups (
conclusionTwo-fold up-dosing of bilastine improves CSU symptoms without compromising safety as compared to two-fold up-dosing of fexofenadine and combination of first- and second-generation antihistamines.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.