Abstract Background: Bilastine is a newer second-generation antihistamine. The present study was undertaken to evaluate the efficacy and safety as compared to earlier existing second generation antihistaminics. Materials and Method: This was a prospective, randomized, double blind, parallel-group comparative study conducted on 76 patients diagnosed with chronic spontaneous urticaria (CsU). Participants were assigned to receive either levocetirizine 5 mg or bilastine 20 mg once daily for a duration of 6-weeks. Objectives: The primary objective was to assess the difference in the Mean Total Symptom Score (MTSS) between baseline and the end of the 6-week treatment period. Secondary objectives included evaluating changes in the number of wheals, pruritus severity, wheal size, and interference of wheals with sleep, sedation using a Visual Analogue Scale (VAS), intensity of erythema, and the Scale for Extent of Skin Area Involvement (SESI). Results: Both bilastine and levocetirizine led to a significant reduction in the Mean Total Symptom Score (MTSS), average number of wheals, and mean pruritus scores from baseline to weeks 1, 3, and 6. However, the reduction in MTSS was significantly greater in the bilastine group. Levocetirizine was associated with a notably higher increase in the Visual Analogue Scale (VAS) score for sedation compared to bilastine. Both medications were generally well tolerated and considered safe. Conclusion: Bilastine demonstrated greater efficacy than levocetirizine in patients with CsU, with rapid noticeable improvement observed as early as one week—an effect that was not evident in the levocetirizine group.
International Journal of Medical Science and Advanced Clinical Research (IJMACR) (Fri,) studied this question.