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Efficacy of increased doses of nonsedating antihistamines in patients with chronic urticaria. *Fexofenadine 120 mg vs Fexofenadine 240 mg p = 0.01, ¶ Fexofenadine 120 mg vs Rupatadine 20 mg p = 0.0001, ♦ Fexofenadine 240 mg vs Rupatadine 20 mg p = 0.03.B) According to percentage of symptom-free patients.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.♦ Desloratadine 10 mg vs Bilastine 80 mg p = 0.002.♠ Desloratadine 20 mg vs Bilastine 40 mg, Desloratadine 20 mg vs Bilastine 80 mg, Levocetirizine 10 mg vs Bilastine 40 mg p = 0.02.

It encompasses two major subtypes: chronic spontaneous urticaria (CSU) (previously known as chronic idiopathic urticaria) (CIU) and chronic inducible urticaria.Among those, 3 papers dealing with the treatment of patients with CSU were excluded from analysis because of their open design, 2 employing cetirizine and one that utilized ebastine [].Another study by Metz et alwas also excluded because it assessed exclusively the effects of a 20 mg dose of rupatadine in patients with acquired cold urticaria whereas no comparisons with other doses of the drug were done [ summarizes the details from 8 double-blind, placebo-controlled studies included in this report.CSU has been defined as wheals and/or angioedema that are endogenous and independent of any external physical stimulus. In 40 to 45% of patients with CSU autoantibodies to the high affinity Ig E receptor (FcϵRI) or to Ig E itself are thought to play a psathogenic role, whereas 55 to 60% of cases are considered idiopathic [].Inducible urticarias include all forms of physical urticarias (cold-induced, heat-induced, solar, and pressure urticaria).

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