Urticaria and the role of Bilastine in its management
19 May 2025
Key messages
Urticaria is a mast-cell mediated disorder with a lifetime prevalence of approximately 20%; chronic cases can impair quality of life to a degree comparable to triple coronary artery disease
Diagnosis is primarily clinical and management follows a rigorous treatment ladder where second-generation antihistamines are the cornerstone
Overview
Urticaria is defined by the development of skin lesions known as wheals and/or angioedema. It is categorized as acute (lasting less than 6 weeks) or chronic (more than 6 weeks), with the latter affecting roughly 0.1-3% of the population.
The underlying pathogenesis is driven by mast cell activation, leading to the release of histamine and other inflammatory mediators.
Management guidelines prioritize a stepwise approach where second-generation antihistamines are a first-line treatment. First-generation antihistamines are no longer recommended due to significant CNS and cardiac side effects.
