The content of this evidence summary was up-to-date in July 2014.See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA or NICE websites for up-to-date information.Patients in the increased cetirizine dose group showed significant improvements in the severity of wheal and itching and in quality of life.
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The efficacy and safety of omalizumab for CIU was demonstrated in two clinical studies that showed omalizumab significantly improved the mean weekly Itch Severity Score (ISS) from baseline by 9.4-9.6 in the 300-mg treatment arm (The dosing for use in asthma is based on weight and Ig E levels, but omalizumab can be administered in 150- or 300-mg doses and, unfortunately, there are no clinical markers that can predict whether or not it will be effective.
Although the evidence supporting its efficacy in treating urticaria is of high quality, the cost of the drug may preclude its use in many patients.
Nevertheless, cetirizine 20 mg appears to be well tolerated and the benefits may outweigh the risks for some people whose quality of life is significantly impaired by the condition.
No data are available from high quality studies on the use of cetirizine at doses higher than 20 mg.
Research into aspects of pharmacokinetics and efficacy and adverse effect profiles of bilastine in children under 12 years of age is needed as are dose-response assessments and studies planned rigorously with the aim of assessing quality of life effects.
Current guidelines for diagnosis and treatment of allergic rhinoconjunctivitis and urticaria recommend nonsedating antihistamines as first line treatment [1, 2].
Bilastine is a new, well-tolerated, nonsedating H1 receptor antihistamine.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
In a recent paper from Japan it was observed that the improvement rates (defined as a urticaria symptom score UAS ≤ 3) in 117 CU patients who received standard doses of AHs were 36.6% at 12 months, 51.2% at 24 months, and 66.1% at 60 months, while the remission rates were 11.5%, 13.9%, and 27.7%, respectively .