Efficacy and Safety of Bilastine vs Other Oral Antihistamines in Treatment of Allergic Rhinitis

Systematic review and meta-analysis of randomized controlled trials (RCTs)

Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Science Direct and Google Scholar up to March 2021 databases were searched

RCTs comparing bilastine with placebo and standard pharmacotherapy were included

Studies which had confirmed diagnosis of AR by clinicians and outcomes with a minimum follow-up period of 2 weeks were eligible

The quality of evidence was evaluated based on GRADE approach

Total symptom score (TSS)

Nasal symptom score (NSS)

Non-nasal symptom score (NNSS)

Rhinitis-associated discomfort score

Quality of life (QOL)

Adverse events (AEs)

Finally, the meta-analysis included 5 trials involving 3,329 patients

There was significant improvement in TSS, NSS, NNSS, rhinitis discomfort score and QOL with bilastine as compared to placebo

However, bilastine demonstrated comparable efficacy with other OAHs in TSS, NSS, NNS, rhinitis discomfort score and QOL

The most common AEs were headache, somnolence and fatigue

There was no difference in the incidence of AEs when bilastine was compared against placebo and other OAHs except for somnolence

Bilastine was associated with lower incidence of somnolence compared to cetirizine

Bilastine was effective and safe in treating the overall symptoms of allergic rhinitis (AR) based on moderate to high quality evidence

The efficacy and safety of bilastine was comparable with other OAHs except somnolence

Bilastine and cetirizine were equally effective, however, somnolence was significantly less with bilastine