A Study To Compare The Efficacy and Safety of Oral Bilastine V/S Oral Levocetrizine in Patients of Allergic Rhinitis

Introduction

“Rhinitis is defined clinically as having two or more symptoms of anterior or posterior rhinorrhoea, sneezing, nasal blockage and/or itching of the nose during two or more consecutive days for more than one hour on most days”.¹ When airborne allergens are inhaled, they cause inflammation in the nasal mucosal lining, leading to allergic rhinitis (AR), a common prevalent condition affecting a significant portion of the global population (0.8-39.7%).²

AR is subdivided into following types:³

1.      Based on timing-

·        Intermittent Allergic Rhinitis (IAR) disease

·        Persistent Allergic Rhinitis (PER) disease

2.      Based on severity-

·        Mild

·        Moderate to severe

The management of AR advocates the allergen avoidance and use of pharmaco- and immune-therapy.

As per Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines,⁴ “the preferred first-line treatment for Allergic Rhinitis (AR) is second-generation H1-antihistamines, which selectively block histamine H1 receptors and reduce symptoms with minimal sedation.”

Among these, Levocetirizine, the R-enantiomer of cetirizine, is a potent, highly selective second-generation H1-antihistamine with a rapid onset of action. It exhibits high H1-receptor affinity, which contributes to its effectiveness in alleviating sneezing, nasal congestion, and rhinorrhea. Levocetirizine demonstrates anti-inflammatory properties, inhibiting eosinophil migration and reducing the late-phase allergic response.⁵