Bilastine 20mg tablets

BackgroundOral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR).ObjectiveTo perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR.MethodsWe searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH versus placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis.ResultsWe included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as "low" or "very low," indicating substantial uncertainty regarding the treatment effects.ConclusionsAlthough some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.

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Allergic rhinitis (AR) significantly impairs quality of life and often necessitates combination therapies for optimal symptom control. This study aimed to evaluate the efficacy of montelukast-antihistamine combination therapy in patients with AR by using a network meta-analysis. A comprehensive search was conducted using PubMed, Embase, MEDLINE, Scopus, the Cochrane Library, and Google Scholar up to April 2025. The treatment strategies included montelukast alone, antihistamine monotherapies (loratadine, desloratadine, levocetirizine, and fexofenadine), their respective combinations with montelukast, including bilastine. Outcomes included daytime and nighttime symptom scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and individual symptoms. Both pairwise and network meta-analyses were conducted. Thirty studies (4,486 patients) were included. Montelukast combinations with desloratadine (standardized mean difference [SMD] = -0.51), levocetirizine (SMD = -0.44), and loratadine (SMD = -0.31) significantly improved daytime nasal symptoms compared to montelukast alone. Only montelukast-levocetirizine improved nighttime symptoms (SMD = -0.21) and RQLQ (SMD = -0.48). The combinations with desloratadine or levocetirizine were superior for nasal obstruction, sneezing, and itching, while nasal discharge improved only with montelukast-levocetirizine. No treatment significantly improved eye symptoms. Surface under the cumulative ranking curve rankings generally favored combination therapies, though trends varied by outcome. Desloratadine monotherapy ranked highest for nasal itching. Although some comparisons require cautious interpretation, montelukast-based combination therapy demonstrated greater efficacy than monotherapy for multiple AR symptoms. These results highlight the importance of selecting therapeutic strategies based on the predominant symptom profile of individual patients.

Abstract licence: CC BY-NC

Background Cough in common cold is often associated with rhinorrhoea and nasal congestion, requiring treatment with a cough suppressant, decongestant, and antihistamine. Bilastine is a non-sedating antihistamine, a preferred option over sedating antihistamines. A combination of bilastine, dextromethorphan, and phenylephrine is expected to provide non-sedating treatment for cough associated with a common cold or allergy. Methods In this open-label, randomized, active-controlled, multicentre, clinical trial, adult and adolescent subjects with acute dry cough received bilastine 6.6 mg/dextromethorphan 20 mg/phenylephrine 10 mg syrup (BDP) thrice daily or Alex® syrup (chlorpheniramine maleate 4 mg/dextromethorphan 20 mg/phenylephrine 10 mg) for seven days. The objective of the study was to evaluate the efficacy and safety of a fixed-dose combination syrup of bilastine, dextromethorphan, and phenylephrine in cough relief in patients with cough associated with a common cold or allergy. Results Of 134 randomized subjects, 67 received BDP and the remaining 67 received Alex® syrup. The least-square mean (LSM) standard error (SE) change in cough severity from baseline on day 4 was 37.86 mm (2.012) in the BDP group (p < 0.001), with a mean difference between the two groups of −4.09 mm (95% CI: −9.68, 1.51). The confidence interval was within the non-inferiority (NI) limits of 30 mm, proving non-inferiority to Alex® syrup (p-value for NI < 0.001). The drowsiness score was significantly lower in the BDP group on day 2 (difference −0.46, p = 0.004), day 4 (difference −0.99, p < 0.001), and day 8 (difference −0.97, p < 0.001). No serious or severe adverse event was reported, and adverse events were comparable between the two groups. Conclusion Bilastine/dextromethorphan/phenylephrine combination syrup is efficacious, safe, non-sedating, and non-inferior to Alex® syrup in the treatment of acute dry cough due to a common cold or allergy.

Abstract licence: CC BY