July 2022

Allergic diseases are immunological reactions with symptoms that may impact quality of life. Bilastine, is a novel oral second-generation H-1 antihistamine, with high selectivity to H1 receptors and with anti-inflammatory properties, however there is not enough evidence regarding the drug efficacy.

The objective of this study was to assess the efficacy and safety of bilastine compared with placebo and other active antihistamines in patients with allergic rhinitis or chronic urticaria.

A literature search was made for randomized controlled trials which assessed bilastine effects on symptomatic hyper histaminic allergic conditions. 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 allergic rhinitis and urticaria was collected. Other outcomes such as clinical global impression and safety profiles were reported. The studies were statistically analysed.

The analysis included 9 randomized controlled trials which included 3801 participants. The meta-analysis shown that bilastine was superior to placebo, improving TSS, TNSS, VAS, and QoL in participants with allergic rhinitis or chronic urticaria. Furthermore, bilastine was comparable to other antihistamines such as cetirizine, fexofenadine, and loratadine regarding these outcomes, with a safe and tolerable profile and with no difference in the incidence of adverse events.

In conclusion, bilastine improved TSS in hyper histaminic allergic conditions involving nasal symptoms in allergic rhinitis with a safe and effective manner. It decreased the discomfort associated with the condition resulting in better QoL of the participants.

Rhinitis is an inflammation of the nasal epithelium, leading to rhinorrhoea, nasal blockage, itching and sneezing. Allergic rhinitis is the most common form of rhinitis and occurs following exposure to allergens. Bilastine is one of the non-sedating second generation H1 oral antihistamines for allergic rhinitis. The objective of this study was to review the efficacy and safety of bilastine in treating allergic rhinitis.

This review was made after an electronic literature search of bilastine-related publications of randomized controlled trials comparing bilastine with placebo and standard pharmacotherapy up to March 2021. The included studies had to have description of diagnosis of AR established by clinicians and the outcomes with a minimum of 2 weeks of follow-up period.

The primary outcomes evaluated were total symptom score (TSS), nasal symptom score (NSS) and non-nasal symptom score (NNSS). The secondary outcomes were discomfort due to rhinitis, quality of life (QoL) and adverse events. The risk of bias and quality of evidence for all studies were also taken into consideration.

There were 135 records identified on the literature search after removal of duplicates. Following screening and review, 15 full-text articles were evaluated for eligibility. Five trials involving 3,329 patients met the inclusion criteria.

From the five trials included, bilastine was superior to placebo in improving TSS, NSS, NNSS, rhinitis discomfort score and QoL but demonstrated a comparable efficacy with other oral antihistamines in TSS, NSS, NNS, rhinitis discomfort score and QoL. The only adverse event where bilastine showed difference from placebo was in somnolence, and also with fewer incidence of somnolence compared to cetirizine. The overall quality of evidence ranged from moderate to high quality.

In conclusion, bilastine is safe and effective in the treatment of overall symptoms of allergic rhinitis with comparable efficacy and safety with other antihistamines except somnolence: while bilastine has a comparable efficacy to cetirizine, somnolence is notably fewer in bilastine.