Abstract:
This case study highlights the clinical effectiveness and safety of Bilastine, a second-generation non-sedating antihistamine, in the management of Chronic Spontaneous Urticaria (CSU). A 56-year-old male with severe CSU unresponsive to loratadine, hydroxyzine, and multiple prednisolone courses—and complicated by comorbid Type 2 diabetes, obesity, and impaired renal function—was initiated on Bilastine 20 mg once daily. Within the first week, the patient demonstrated substantial symptom improvement with a reduction in UAS7 score from 28 to 12. Subsequent titration to Bilastine 40 mg once daily further improved disease activity, achieving a UAS7 score of 6, with better control of hives and angioedema. Bilastine’s non-sedating profile, minimal drug–drug interactions, P-glycoprotein–mediated low CNS penetration, and safety in hepatic and renal impairment positioned it as an optimal therapeutic choice. This real-world experience supports existing evidence that Bilastine up-dosing is effective in refractory CSU, improving symptom control and quality of life while avoiding sedation, cognitive impairment, and metabolic complications. These outcomes reinforce Bilastine as a preferred, safe, and long-term antihistamine for chronic urticaria management, particularly in patients with multiple comorbidities.
The full case study, including clinical details and follow-up data, is available in the attached PDF.
