urticaria archivos - Page 4 of 4

Nov 27

CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria

By Bilastina Selected articles

Fein MN, Fischer DA, O’Keefe AW, Sussman GL.

Allergy Asthma Clin Immunol. 2019 Oct 1;15:61. doi: 10.1186/s13223-019-0375-9. eCollection 2019. Review.

H1-antihistamines are the most used class of medications for the treatment of allergic rhinitis and urticaria. The first generation of antihistamines has been available since 1946, however its common side effects, such as sedation, impairment with decreased cognitive function, poor sleep quality, dry mouth, dizziness and orthostatic hypotension led to the development of newer, less-sedating second and third generation antihistamines, which became available in the 1980s. These newer generations of H1-antihistamines have a better safety profile and improved potency and efficacy. They are the recommended first-line treatment for mild allergic rhinitis and acute and chronic urticaria.

The Canadian Society of Allergy Clinical Immunology (CSACI) recommends that second and third generations of H1-antihistamines are preferred over first generation antihistamines for the treatment of allergic rhinitis and urticaria. CSACI also recommends that first generation antihistamines should only be sold behind the counter in pharmacies and as a last resort due to the risks of their use.

To help change practice and improve patient health and safety, the CSACI recommends that efforts are needed to disseminate this information to healthcare providers and patients.

This document is only available for registered healthcare professionals

Nov 27

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The safety and tolerability profile of bilastine for chronic urticaria in children

By Bilastina Articles about Bilastine

Papadopoulos NG, Zuberbier T.

Clin Transl Allergy. 2019 Oct 23;9:55. doi: 10.1186/s13601-019-0294-3. eCollection 2019. Review.

Urticaria is characterized by the development of pruritic wheals, angioedema or both. Guidelines from early 2018 recommend that urticaria is classified based on its duration as acute (< 6 weeks) or chronic (> 6 weeks). In addition, they also classify chronic urticaria as spontaneous or inducible. Chronic urticaria is less frequent than acute in children, but is a condition that requires treatment, as it affects children’s daily activities, disturbs sleep, causes emotional distress and influences negatively learning and cognition.

Bilastine is a H1-antihistamine that has been studied in children at the dose of 10mg/daily and is licensed for the symptomatic relief of urticaria symptoms in children > 6 to 11 years.

Investigation in paediatric population included bilastine and rupatadine among the second-generation antihistamines. A phase III, doubleblind, randomized, placebo-controlled, parallel-group clinical trial was carried out to assess the safety and tolerability of bilastine 10 mg once daily for 12 weeks in 509 children aged 2–11 years with allergic rhinitis or chronic urticaria. The primary endpoint was the proportion of children in each treatment group without treatment-emergent adverse events (TEAEs). Secondary endpoints included the assessment of somnolence/sedation with the Pediatric Sleep Questionnaire (PSQ). No statistically significant differences were found between treatment groups for incidences of TEAEs or related TEAEs in the population overall or by age subgroup. The majority of related TEAEs were mild to moderate in intensity. PSQ scores for somnolence/sedation decreased slightly from baseline to week 12 in both the bilastine 10 mg and placebo groups.

In conclusion, bilastine is a suitable for treatment of urticaria in children, due to its efficacy and good tolerability profile that were proven in well-controlled studies. Specifically, lack of potential to induce sedation allows prolonged administration without impairment of performance and learning abilities.

This document is only available for registered healthcare professionals

Nov 19

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Bilastine: a lifetime companion for the treatment of allergies

By Bilastina Articles about Bilastine

Martin K. Church, Marysia Tiongco-Rectob, Erminia Ridoloc and Zoltan Novàk.

Bilastine is a potent and highly selective H1-antihistamine approved for the treatment of allergic rhinoconjunctivitis and urticaria. This article summarizes available data on the use of bilastine in the treatment of allergic disorders in different age groups, including younger and older adults, and school-age children and adolescents.

This document is only available for registered healthcare professionals

Nov 08

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Prevalence of chronic urticaria in children and adults across the globe: systematic review with meta-analysis

By Bilastina Selected articles

Fricke J, Ávila G, Keller T, Weller K, Lau S, Maurer M, Zuberbier T, Keil T.

(2019) Allergy. 2019 Sep 8. doi: 10.1111/all.14037. [Epub ahead of print]

Urticaria is a relatively common skin condition, characterized by the development of hives, angioedema, or both. Although it is a common condition, there are few studies that assess urticaria prevalence and do not distinguish between acute and chronic forms.

This review aimed at examining the prevalence of chronic urticaria by assessing the evidence from population-based studies worldwide.

After a systematic search in PUBMED and EMBASE for population-based studies of cross-sectional or cohort design and studies based on health insurance/system databases, 18 studies were included in the systematic evaluation and 11 in the meta-analysis, including data from over 86,000,000 participants.

Globally, the prevalence of chronic urticaria showed considerable regional differences. Asian studies showed a higher point prevalence of chronic urticaria than those from Europe and Northern America. Women seemed to be more affected than men, whereas in children < 15 years there was no sex-specific difference in the prevalence of chronic urticaria. Four of the studies that examined time trends, indicated an increasing prevalence of chronic urticaria over time.

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Nov 06

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investigacion seguridad cardiaca antihistaminicos

Cardiac safety of second-generation H1-antihistamines when updosed in chronic spontaneous urticaria

By Bilastina Selected articles

Mauro Cataldi, Marcus Maurer, Maurizio Taglialatela, Martin K. Church2.

(2019) Clin Exp Allergy. 2019 Sep 13. doi: 10.1111/cea.13500. [Epub ahead of print]

This is a review where the mechanisms and assessment of potential cardiotoxicity of H1-antihistamines are discussed when updosed to four-times their licensed dose. Second generation H1-antihistamines are the primary treatment of chronic urticaria, however there are patients who don’t respond to licensed doses of H1-antihistamines. Current EAACI/GA2LEN/EDF/WAO guideline for urticaria suggest updosing of H1-antihistamines up to 4-fold.

Due to the off label use of this updosing, it is important to ensure its safety. An important aspect of safety is potential cardiotoxicity. This review considered in detail H1-antihistamines such as bilastine, cetirizine, levocetirizine, ebastine, fexofenadine, loratadine, desloratadine, mizolastine and rupatadine. Provided that prescribers carefully considered and ruled out potential risk factors for cardiotoxicity, such as the presence of inherited long QT syndrome, older age, cardiovascular disorders, hypokalemia and hypomagnesemia, or the use of drugs that either haver direct QT prolonging effect or inhibit H1-antihistamines metabolism, reviewers were able to conclude that at up to four-fold the standard dose, H1-antihistamines have excellent cardiac safety profiles.

This document is only available for registered healthcare professionals.

Jul 26

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Efficacy and safety of bilastine in reducing pruritus in patients with chronic spontaneous urticaria and other skin diseases: an exploratory study

By Bilastina Eprint

Esther Serra, Cristina Campo, Zoltan Novak, Bernadetta Majorek-Olechowska, Grazyna Pulka, Aintzane García-Bea and Luis Labeaga

Pruritus is a common symptom associated with different skin diseases, including urticaria, atopic dermatitis, eczema and prurigo. Pruritus may have a significant impact on the quality of life and psychosocial wellbeing of patients with skin urticaria. Bilastine is a H1-antihistamine with demonstrable efficacy for the symptomatic treatment of chronic spontaneous urticaria.

A phase IV, multicentre, open-label, exploratory study to evaluate the efficacy and safety of bilastine in reducing pruritus in patients with chronic spontaneous urticaria and other skin diseases was conducted at 10 European Centres.

115 patients between 18 and 74 years diagnosed with chronic spontaneous urticaria, eczema/dermatitis, prurigo or cutaneous pruritus who had not responded to placebo during a run-in period of 7-14 days and with, at least 4 points for the sum of itch score during the last 3 days of the run-in period were included. Patients received bilastine 20 mg once daily for 8 weeks and non-responders (<30% improvement in pruritus score at week 2), received 40 mg daily from week 2.

Bilastine reduced the mean change in weekly pruritus severity score from baseline to week 8 (primary endpoint) (overall and by disease group). Up dosed non-responders (n = 31) improved weekly pruritus severity scores from baseline to week 8. Bilastine improved the Dermatology Life Quality Index at weeks 4 and 8 (p < 0,001) in all disease groups, and the 7-day Urticaria Activity Score in CSU patients (p <0 ,001).

In conclusion, bilastine has demonstrated efficacy for the relief of pruritus associated with urticaria and other skin diseases in adults, with a very good safety profile. Also, bilastine up dosing to 40mg (double dose), for patients who did not achieve a significant improvement after 2 weeks of treatment, was efficacious without any safety concerns.

This document is only available for registered healthcare professionals.

May 31

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Skin microdialysis: methods, applications and future opportunities – an EAACI position paper

By Bilastina Selected articles

Katrine Y. Baumann, Martin K. Church, Geraldine F. Clough, Sven Roy Quist, Martin Schmelz, Per Stahl Skov, Chris D. Anderson, Line Kring Tannert, Ana Maria Giménez‑Arnau, Stefan Frischbutter, Jörg Scheffel and Marcus Maurer

(2019) Clinical and Translational Allergy

An EAACI Task Force on Skin Microdialysis was formed to gain knowledge about the technique and its applications in chronic inflammatory skin diseases, such as atopic dermatitis, chronic urticaria, psoriasis and other hypersensitivity reactions.

Skin microdialysis is a versatile sampling technique that can be used to recover soluble endogenous and exogenous molecules from the extracellular compartment of human skin. It is minimally invasive and can be applied in both clinical and preclinical settings, however it has still not reached its full potential use as a tool to explore pathophysiological mechanisms of allergic and inflammatory reactions in the skin.

Thin tubular dialysis membranes are inserted into the dermis or the subcutis and perfused at a low speed with a physiological solution. Molecules soluble in the extracellular fluid diffuse into the tubular microdialysis membrane and are collected in small vials for analysis.

Signs and symptoms of urticaria (itchy wheals and angioedema) can be induced by skin provocation with relevant triggers, which makes skin microdialysis ideal for the investigation of inducible urticaria. It has also been used to monitor the therapeutic effect of desensitization or antihistamines in cold urticaria patients by measuring histamine or cytokine release in response to cold provocation. It has shown that cold challenged patients with cold urticaria treated with increased doses of bilastine, significantly reduced late phase histamine and proinflammatory cytokine release.

In conclusion, there is still a huge potential for skin microdialysis to become a standard and routinely used technique in experimental dermatology and allergology, as it provides quantifiable data of the mediators involved in the inflammatory response in situ.

This document is only available for registered healthcare professionals

May 31

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The real-life effectiveness and safety of omalizumab updosing in patients with chronic spontaneous urticaria

By Bilastina Articles about Bilastine

Andac Salman and Elif Comert

(2019) Journal of Cutaneous Medicine and Surgery

A retrospective cohort study was conducted to investigate the effectiveness and safety of 450 mg of omalizumab in chronic spontaneous urticaria.

Omalizumab is a third-line treatment for chronic spontaneous urticaria, however there are not enough studies regarding its use in patients that are unresponsive to regular doses of omalizumab.

A total of 72 patients were included, according to their Urticaria Activity Score over 7 days and the Urticaria Control Test and divided in two groups. Group 1 (n=59) included those showing a complete response to omalizumab 300 mg and group 2 (n=13) included those who received at least 3 doses of omalizumab 450 mg between 2016 and 2018.

The mean Urticaria Activity Score over 7 days decreased from 18,6 to 5,1 and the mean Urticaria Control Test score increase from 8,6 to 12 in group 2 participants after a mean 4,3 courses of omalizumab 450 mg. Of all 13 participants from group 2, 6 of them had a complete response, and 3 a good disease control. Those whose response to treatment was lower had low baseline total IgE levels (<43 IU/mL).

In conclusion, this team demonstrated that higher doses of omalizumab are effective and safe in patients with chronic spontaneous urticaria that is unresponsive to omalizumab 300 mg. Also, they predict that lower baseline total IgE levels might be related to a nonresponse to omalizumab and the need for higher doses.

This document is only available for registered healthcare professionals

May 31

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Autoimmune theories of chronic spontaneous urticaria

By Bilastina Selected articles

Sonali J. Bracken, Soman Abraham and Amanda S. MacLeod

Different theories exist to describe the pathogenesis of chronic spontaneous urticaria. A group of investigators highlighted in this study the evidence surrounding the autoimmune pathogenesis of chronic urticaria, a condition which persists for more than 6 weeks in duration and occurs in the absence of an identifiable provoking factor.

Chronic spontaneous urticaria results from pathogenic activation of mast cells and basophils, which releases proinflammatory mediators of urticaria. Recent data suggests that chronic spontaneous urticaria may involve contributions from both immunoglobin G (IgG)-specific and immunoglobulin E (IgE)-specific autoantibodies against a vast array of antigens that can span beyond those found on the surface of mast cells and basophils, contributing to the severity of the disease and predisposing people to the development of additional autoimmune diseases.

People with chronic spontaneous urticaria mediated by IgE autoantibodies appear to have a faster onset of improvement in response to omalizumab than those with IgG-mediated disease.

This document is only available for registered healthcare professionals

Apr 25

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Chronic Urticaria: An Overview of Treatment and Recent Patents

By Bilastina Selected articles

Hon KLE, Leung AKC, Ng WGG, Loo SK.

Chinese investigators provided an update on the epidemiology, pathogenesis, clinical manifestations, diagnosis, aggravating factors, complications, treatments and prognosis of chronic urticaria.

They searched for meta-analyses, randomized controlled trials, clinical trials, reviews and other pertinent references.

Chronic urticaria is a clinical diagnosis, based on the appearance of characteristic urticarial lesions that wax and wane rapidly, with or without angioedema, most days of the week for more than six weeks. It is a common, debilitating and hard to treat condition. Medications, physical stimuli and stress can be the trigger of 10-20% of cases. After ruling out an underlying disorder, second generation H1 antihistamines are the choice for initial therapy. These are often safe and effective.

When an improvement does not occur in 2-4 weeks of treatment, the dose can be increased up to fourfold the recommended dose. If improvement does not occur after increase in the dosage, omalizumab should be added.

When a satisfactory improvement does not happen after 6 months or earlier, or if symptoms are intolerable after omalizumab, there is still the possibility of treatment with cyclosporine and second generation H1 antihistamines.

Short-term use of oral corticosteroids may be considered for acute exacerbation of chronic urticaria or in refractory cases.

In conclusion, chronic urticaria is an idiopathic disease in most cases, with the average duration of two to five years. Complications may include skin excoriations, adverse effect on quality of life, anxiety and depression. Treatment is primarily symptomatic with second generation antihistamines on the first line of treatment. Omalizumab has been showing a good support in the management of chronic urticaria and improves patients’ quality of life.

This document is only available for registered healthcare professionals

Mar 25

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Real-life experience in the treatment of solar urticaria: retrospective cohort study

By Bilastina Selected articles

Snast I, Lapidoth M, Uvaidov V, Enk CD, Mazor S, Hodak E, Levi A.

Solar urticaria (SU) is a rare photodermatosis causing a significant impact on patients’ quality of life. Treatment is often challenging. This study presents our clinical experience with a tailored stepwise therapeutic approach.

This document is only available for registered healthcare professionals

Mar 25

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Diagnosis, pathogenosis, and treatment of chronic spontaneous urticaria (e-Print)

By Bilastina Eprint, Selected articles

Allen P, Kaplan M.D.

Diagnosis, pathogenosis, and treatment of chronic spontaneous urticaria (CSU)

High doses of antihistaminic, omalizumab and ciclosporina (in this order) are effective and advisable for Chronic Spontaneous Urticaria (CSU) therapy, an inflammatory skin disease associated to autoimmunity in 45% of patients.

e-Print. Free download until end of purchased units.
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urticaria

CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria

The safety and tolerability profile of bilastine for chronic urticaria in children

Bilastine: a lifetime companion for the treatment of allergies

Prevalence of chronic urticaria in children and adults across the globe: systematic review with meta-analysis

Cardiac safety of second-generation H1-antihistamines when updosed in chronic spontaneous urticaria

Efficacy and safety of bilastine in reducing pruritus in patients with chronic spontaneous urticaria and other skin diseases: an exploratory study

Skin microdialysis: methods, applications and future opportunities – an EAACI position paper

The real-life effectiveness and safety of omalizumab updosing in patients with chronic spontaneous urticaria

Autoimmune theories of chronic spontaneous urticaria

Chronic Urticaria: An Overview of Treatment and Recent Patents

Real-life experience in the treatment of solar urticaria: retrospective cohort study

Diagnosis, pathogenosis, and treatment of chronic spontaneous urticaria (e-Print)

Diagnosis, pathogenosis, and treatment of chronic spontaneous urticaria (CSU)

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