A Comparative Study to Assess the Efficacy and Safety of Bilastine Versus Fexofenadine for the Treatment of Chronic Urticaria

Abstract

Background: Chronic Urticaria (CU) is a debilitating dermatological condition significantly impacting patient quality of life. Second-generation H1-antihistamines, such as bilastine and fexofenadine, are universally recommended as the first-line pharmacologic treatments. A direct comparative analysis is required to determine their relative efficacy and safety in achieving sustained symptom control and improving patient-reported outcomes. Materials and Methods: A prospective observational study was conducted, involving 73 adult patients diagnosed with CU. Each patient was observed for periodic reduction in symptoms over the duration of 4 weeks along with overall quality of life assessment before and after treatment. Efficacy was evaluated using the Urticaria Activity Score (UAS) as the primary endpoint and the Dermatology Life Quality Index (DLQI) as the secondary endpoint. Statistical analysis was performed using Microsoft Excel and SPSS (version 27). Results: The study cohort comprised 73 patients with a mean age of 35.75 ± 13.22 years. Both treatment groups (Bilastine and Fexofenadine) were comparable at baseline with no significant difference in initial symptom distribution. Clinical improvements in effectiveness were observed through both DLQI and UAS score evaluations. Bilastine consistently outperformed fexofenadine with statistically significant difference of p<0.001, showing a marked reduction in disease activity over the treatment period. Conclusion: Bilastine demonstrated superior efficacy compared to fexofenadine in alleviating CU symptoms and improving patient quality of life. Both medications were well tolerated, with adverse effects occurring infrequently and no major safety concerns emerging from the comparative analysis. This study recommends bilastine as a highly effective and safe first-line treatment option for chronic urticaria.