Abstract:
This case study demonstrates the clinical value of Bilastine, a second-generation non-sedating antihistamine, in the management of Chronic Spontaneous Urticaria (CSU) in a patient whose occupation demands alertness—professional driving. A 47-year-old male truck driver with a two-year history of recurrent wheals, intense pruritus, dermographism, and angioedema was initially treated with escalating doses of levocetirizine, which produced symptom relief but caused disabling sedation affecting daily functionality and driving performance. On transitioning to Bilastine 20 mg once daily, the patient reported marked improvement within 14 days, reflected by substantial reductions in UAS7 and UCT scores. Dose escalation to Bilastine 40 mg twice daily resulted in complete symptom control, with no sedation, no impairment of psychomotor performance, and no impact on occupational functioning. This real-world outcome supports extensive clinical evidence that Bilastine offers potent H1-antihistamine activity, rapid onset, long duration, and minimal CNS penetration, making it especially suitable for patients whose jobs require vigilance. It further reinforces Bilastine’s utility in cases refractory to levocetirizine and other antihistamines, as well as its proven safety at higher doses without cardiotoxicity or anticholinergic effects. This case highlights Bilastine as a preferred, safe, and occupation-appropriate therapy for CSU management, particularly for individuals engaged in driving or machinery operation.
The full case study, including clinical details and follow-up data, is available in the attached PDF.
