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presents the results of the 8 studies in regard to efficacy of the treatment.It can be observed that the proportion of symptom improvement was highly variable, ranging from 3.4% to 71.6%, depending on the drug and dose.There were not significant differences in efficacy between fexofenadine and bilastine, rupatadine and bilastine, and desloratadine and levocetirizine.However, fexofenadine, rupatadine, and bilastine showed significantly higher efficacy than desloratadine or levocetirizine, and rupatadine had higher efficacy than fexofenadine.When available, efficacy data were pooled from different studies that utilized the same drug dose.

The statistical comparison of the data is shown in Figure .According to the International Guidelines for the management of urticaria and angioedema non-sedating, second generation antihistamines (NSAHs) are recommended for the treatment of CU [].Nevertheless, a considerable proportion of patients do not respond sufficiently to NSAHs.Bilastine belongs to the piperidine class of antihistamines as do loratadine, desloratadine, and fexofenadine.

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Like other antihistamines bilastine is an H1 receptor inverse agonist.It must be noticed, however, that it is difficult to find clinical investigations that strictly follow the criteria recommended by the guidelines on the management of urticaria, and therefore studies included in this review were those in which higher doses of NSAHs were used regardless of the clinical response to conventional doses.

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