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Román M, Ochoa D, Martin S, Luquero S, Gilaberte I, Arranz P, Sánchez C. Bioequivalence and Safety of Bilastine 20 mg Orodispersible Tablets and Conventional Tablets: A Randomized, Single-Dose, Two-Period Crossover Study in Healthy Volunteers Under Fasting Conditions. Drugs R D 2024:10.1007/s40268-024-00480-8. [PMID: 39088184 DOI: 10.1007/s40268-024-00480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Orodispersible tablets (ODT) rapidly dissolve in the oral cavity and can improve patient's convenience. This pharmacokinetic study assessed the bioequivalence of a novel 20 mg ODT formulation of bilastine compared with bilastine 20 mg tablets in healthy volunteers under fasting conditions. METHODS A phase I, single-center, open-label, two-period, two-sequence crossover randomized clinical trial was conducted. The study comprised two periods, in which participants were administered a single oral dose of bilastine 20 mg in the form of ODT as the test product, or conventional tablets as the reference product, and a washout of 7 days between each period. Blood samples were collected for up to 72 h. Bioequivalence was established if the 90% confidence intervals of the Cmax and AUC0-t were within the acceptance range (80-125%). Safety was evaluated at the follow-up visit (days 4-7 after the second dose) and throughout the study. RESULTS A total of 42 healthy volunteers were randomized, and 41 completed the study. Pharmacokinetic parameters were comparable for both formulations after a single dose of 20 mg. Bilastine ODT and conventional tablets were bioequivalent as the 90% confidence intervals of the test over reference ratios were within the predefined range (80-125%). Both formulations were well tolerated and showed a similar safety profile. CONCLUSIONS Bilastine ODT was bioequivalent to the reference treatment formulated as conventional tablets when administered as a single oral dose of 20 mg under fasting conditions. Both formulations showed a similar tolerability and safety profile, with no serious adverse events or significant analytical alterations reported. TRIAL REGISTRATION 2019-004071-39. Date of authorization: 10 December 2019.
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Affiliation(s)
- Manuel Román
- Clinical Pharmacology Department, Hospital Universitario de La Princesa Instituto de Investigación Sanitaria La Princesa (IP), Universidad Autónoma de Madrid (UAM), C/ Diego de León, 62, 28006, Madrid, Spain
| | - Dolores Ochoa
- Clinical Pharmacology Department, Hospital Universitario de La Princesa Instituto de Investigación Sanitaria La Princesa (IP), Universidad Autónoma de Madrid (UAM), C/ Diego de León, 62, 28006, Madrid, Spain
| | - Samuel Martin
- Clinical Pharmacology Department, Hospital Universitario de La Princesa Instituto de Investigación Sanitaria La Princesa (IP), Universidad Autónoma de Madrid (UAM), C/ Diego de León, 62, 28006, Madrid, Spain
| | - Sergio Luquero
- Clinical Pharmacology Department, Hospital Universitario de La Princesa Instituto de Investigación Sanitaria La Princesa (IP), Universidad Autónoma de Madrid (UAM), C/ Diego de León, 62, 28006, Madrid, Spain
| | - Inmaculada Gilaberte
- Department of Research, Development and Innovation, FAES FARMA S. A., C. Vía de los Poblados 3, 28033, Madrid, Spain
| | - Paula Arranz
- Department of Research, Development and Innovation, FAES FARMA S. A., C. Vía de los Poblados 3, 28033, Madrid, Spain
| | - Carlos Sánchez
- Department of Research, Development and Innovation, FAES FARMA S. A., C. Vía de los Poblados 3, 28033, Madrid, Spain.
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Abdelshafy AM, Abdallah SY, Hassan AF, Mohamed HA, Kamal NM, Ali ST, Abdelhaleem IA. The Impact of Bilastine on Symptoms of Allergic Rhinitis and Chronic Urticaria: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Rhinol Allergy 2022; 36:684-694. [PMID: 35593100 DOI: 10.1177/19458924221097449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Allergic diseases are immunological exaggerations with symptoms that may interfere with life quality. Bilastine, a novel oral second-generation H-1 antihistamine, is highly selective to H-1 receptors and has anti inflammatory properties. The present evidence regarding the drug efficacy is inconsistent. OBJECTIVES We aimed to evaluate the efficacy and safety of bilastine compared with the placebo and other active antihistamines in patients who complained either from AR or chronic urticaria. METHODS We systematically searched the Medline, Scopus, Web of Science, and Cochrane databases for randomized controlled trials (RCTs) evaluating bilastine effects on symptomatic hyper histaminic allergic conditions. We collected data on total symptoms scores (TSS), total nasal symptom scores (TNSS), discomfort associated with these allergic conditions measured by visual analog score (VAS), and quality of life (QOL) for AR and urticaria. Other outcomes such as clinical global impression and safety profiles were reported as well. We pooled the studies in a random effect model using RevMan 5.4 software. RESULTS We included 9 RCTs comprising 3801 participants. The meta-analysis revealed that bilastine was superior to placebo, improving TSS, TNSS, VAS, and QOL in AR or chronic urticaria participants. Moreover, the bilastine was comparable to active antihistamines such as cetirizine, fexofenadine, and loratadine regarding mentioned outcomes. In addition, the novel drug was safe and tolerable with no difference in the incidence of adverse events with a placebo. CONCLUSIONS Bilastine safely improved TSS in hyper histaminic allergic conditions involving nasal symptoms in AR. It decreases the discomfort associated with the disease resulting in improving the QOL of the participants.
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Affiliation(s)
- Aliaa M Abdelshafy
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
| | - Sara Y Abdallah
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
| | - Ahmed F Hassan
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
| | - Hazem A Mohamed
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
| | - Nourhan M Kamal
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt.,68103Ministry of Health and Population, Cairo, Egypt
| | - Sohila T Ali
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
| | - Ibrahim A Abdelhaleem
- 68865Faculty of Medicine, Zagazig University, Zagazig, Egypt.,68865Zagazig Medical Research Society, Zagazig, Egypt
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Pharmacokinetics and Safety of a Bilastine Once-Daily, Preservative-Free, Ophthalmic Formulation. Adv Ther 2021; 38:4070-4081. [PMID: 34125400 PMCID: PMC8280016 DOI: 10.1007/s12325-021-01801-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022]
Abstract
Introduction Bilastine is a second-generation H1 antihistamine indicated for the symptomatic treatment of allergic rhinoconjunctivitis and urticaria. On the basis of the demonstrated efficacy and safety of the oral formulation, a new ophthalmic formulation of bilastine was recently developed. Previous preclinical studies had indicated that bilastine is mainly absorbed by the conjunctiva and shows low plasma concentration. The objective of this study was to evaluate the pharmacokinetics and safety of ophthalmic bilastine (6 mg/mL) after single and multiple dose administration at steady state in healthy adults. Methods This was an open-label, single-centre, phase I, bioavailability clinical trial. One drop of the bilastine ophthalmic formulation was administered once daily in each eye of the subjects for 5 days. Bilastine plasma concentrations were measured by HPLC–MS/MS. Adverse drug reactions were recorded for each subject during drug administration and follow-up visits. Results Twelve healthy subjects (age 18–55 years) were included in the study. After multiple dose administration, bilastine reached a mean (± SD) maximum blood concentrations of 2682.26 ± 1615.88 pg/mL at a median time of 2.50 h (range 1.25–4.00 h). The half-life of bilastine in plasma was 7.88 ± 6.72 h. Steady state AUC was 19,512.51 ± 9248.76 h·pg/mL. Adverse events were mild and transient, consisting mainly of dysgeusia. Conclusions Bilastine once-daily ophthalmic formulation 6 mg/mL is absorbed into the bloodstream in low amounts by the ophthalmic route. The bilastine ophthalmic formulation showed a good safety profile after multiple dose administration.
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Kim C, Lo Re V, Rodriguez M, Lukas JC, Leal N, Campo C, García-Bea A, Suarez E, Schmidt S, Vozmediano V. Application of a dual mechanistic approach to support bilastine dose selection for older adults. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2021; 10:1006-1017. [PMID: 34157202 PMCID: PMC8452293 DOI: 10.1002/psp4.12671] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 01/30/2023]
Abstract
The objective of this study was to evaluate bilastine dosing recommendations in older adults and overcome the limitation of insufficient data from phase I studies in this underrepresented population. This was achieved by integrating bilastine physicochemical, in vitro and in vivo data in young adults and the effect of aging in the pharmacology by means of two alternative approaches: a physiologically‐based pharmacokinetic (PBPK) model and a semi‐mechanistic population pharmacokinetic (Senescence) model. Intestinal apical efflux and basolateral influx transporters were needed in the PBPK model to capture the observations from young adults after single i.v. (10 mg) and p.o. (20 mg) doses, supporting the hypothesis of involvement of gut transporters on secretion. The model was then used to extrapolate the pharmacokinetics (PKs) to elderly subjects considering their specific physiology. Additionally, the Senescence model was develop starting from a published population PK) model, previously applied for pediatrics, and incorporating declining functions on different physiological systems and changes in body composition with aging. Both models were qualified using observed data in a small group of young elderlies (N = 16, mean age = 68.69 years). The PBPK model was further used to evaluate the dose in older subjects (mean age = 80 years) via simulation. The PBPK model supported the hypothesis that basolateral influx and apical efflux transporters are involved in bilastine PK. Both, PBPK and Senescence models indicated that a 20 mg q.d. dose is safe and effective for geriatrics of any age. This approach provides an alternative to generate supplementary data to inform dosing recommendations in under‐represented groups in clinical trials.
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Affiliation(s)
- Chaejin Kim
- Department of Pharmaceutics, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Gainesville, Florida, USA
| | - Valentina Lo Re
- Drug Modeling & Consulting (DMC), Dynakin, SL, Bilbao, Spain.,Department of Pharmacology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU/ Biocruces Health Research Institute, Bizkaia, Spain
| | | | - John C Lukas
- Drug Modeling & Consulting (DMC), Dynakin, SL, Bilbao, Spain
| | - Nerea Leal
- Drug Modeling & Consulting (DMC), Dynakin, SL, Bilbao, Spain
| | | | | | - Elena Suarez
- Department of Pharmacology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU/ Biocruces Health Research Institute, Bizkaia, Spain
| | - Stephan Schmidt
- Department of Pharmaceutics, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Gainesville, Florida, USA
| | - Valvanera Vozmediano
- Department of Pharmaceutics, Center for Pharmacometrics and Systems Pharmacology, University of Florida, Gainesville, Florida, USA
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Rodríguez M, Vozmediano V, García-Bea A, Novák Z, Yáñez A, Campo C, Labeaga L. Pharmacokinetics and safety of bilastine in children aged 6 to 11 years with allergic rhinoconjunctivitis or chronic urticaria. Eur J Pediatr 2020; 179:801-805. [PMID: 31919579 PMCID: PMC7160087 DOI: 10.1007/s00431-019-03559-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/25/2019] [Accepted: 12/23/2019] [Indexed: 12/28/2022]
Abstract
Bilastine, a second-generation antihistamine, is approved in Europe for the treatment of allergic rhinoconjunctivitis and urticaria in adults and children aged ≥ 6 years. Pharmacokinetic data for children aged 6-11 years were extracted post hoc from a study in which children (2-11 years) with allergic rhinoconjunctivitis or urticaria received oral bilastine (10 mg/day). Maximum plasma concentration (Cmax) and area under the plasma concentration curve (AUC) data were compared with adult pharmacokinetic data from seven clinical studies (bilastine 20 mg/day). Safety data for children aged 6-11 years were extracted post hoc from a phase III randomized controlled trial of children (2-11 years) with allergic rhinoconjunctivitis or chronic urticaria receiving once-daily bilastine 10 mg or placebo for 12 weeks. Exposure and Cmax values were similar for children (6-11 years) and adults: median pediatric/adult ratios for AUC0-24 and Cmax were 0.93 and 0.91, respectively. There was no significant difference in the incidence of treatment-emergent adverse in children (6-11 years) receiving bilastine 10 mg or placebo.Conclusion: Pharmacokinetic and safety analyses in children aged 6-11 years support the suitability of the pediatric dose of bilastine 10 mg and confirm that the safety profiles of bilastine and placebo are similar.What is Known:• Bilastine, a second-generation antihistamine, is approved in Europe for the treatment of allergic rhinoconjunctivitis and urticaria in adults (20 mg/day) and children aged ≥ 6 years (10 mg/day).• An ontogenic model based on adult data and pharmacokinetic/pharmacodynamic simulations supported the selection of a bilastine dose of 10 mg/day in children aged 2-11 years. Bilastine 10 mg/day was shown to have a safety profile similar to that of placebo in a large phase III randomized clinical trial in children aged 2-11 years.What is New:• As bilastine is approved in Europe for children aged ≥6 years, the current study reports the results of two post hoc analyses of pharmacokinetic and safety data in children aged 6-11 years.• Analysis of pharmacokinetic and safety data in children aged 6-11 years supports the suitability of the pediatric dose of bilastine 10 mg and confirms that its safety profile is similar to that of placebo.
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Affiliation(s)
| | | | | | - Zoltán Novák
- Aranyklinika Egészségügyi és Innovációs Kft, Szeged, Hungary
| | - Anahí Yáñez
- INAER-Investigaciones en Alergia y Enfermedades Respiratorias, Buenos Aires, Argentina
| | - Cristina Campo
- Medical Department, FAES FARMA, S. A., 48940 Leioa, Bizkaia Spain
| | - Luis Labeaga
- Medical Department, FAES FARMA, S. A., 48940 Leioa, Bizkaia Spain
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Baharudin A, Abdul Latiff AH, Woo K, Yap FBB, Tang IP, Leong KF, Chin WS, Wang DY. Using Patient Profiles To Guide The Choice Of Antihistamines In The Primary Care Setting In Malaysia: Expert Consensus And Recommendations. Ther Clin Risk Manag 2019; 15:1267-1275. [PMID: 31802877 PMCID: PMC6828722 DOI: 10.2147/tcrm.s221059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/14/2019] [Indexed: 01/05/2023] Open
Abstract
H1-antihistamines are recognized to be effective for conditions such as allergic rhinitis and chronic spontaneous urticaria. However, management of such conditions in the real-world primary care setting may be challenging due to diverse patient-specific considerations, the wide range of antihistamines available, choice of other treatment modalities, and the complexity of interpreting specialist treatment algorithms. Despite regular updates to international guidelines, regional/national surveys of healthcare professionals show a clear gap between guidelines and real-world practice, particularly at the primary care level. This article thus presents the consensus opinion of experts from relevant specialties in Malaysia - allergology, pediatrics, otorhinolaryngology, and dermtology - on harmonizing the use and choice of antihistamines in primary care. Patient profiling is recommended as a tool to guide primary care practitioners in prescribing the appropriate antihistamine for each patient. Patient profiling is a three-step approach that involves 1) identifying the individual's needs; 2) reviewing patient-specific considerations; and 3) monitoring treatment response and referral to specialists in more severe or difficult-to-treat cases. Concurrently, guidelct 3ines should be reviewed and updated periodically to include recommendations that are easily actionable for primary care practitioners.
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Affiliation(s)
- Abdullah Baharudin
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Kent Woo
- Allergy and Immunology Clinic, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Felix Boon-Bin Yap
- Department of Dermatology, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia
| | - Ing Ping Tang
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kuching, Sarawak, Malaysia
| | - Kin Fon Leong
- Department of Dermatology, Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Wai Seong Chin
- Pediatric Clinic, Dr Chin's Child Specialist Clinic, Kuala Lumpur, Malaysia
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Vozmediano V, Lukas JC, Encinas E, Schmidt S, Sologuren A, Valiente R, Labeaga L, Campo C, Rodriguez M. Model-informed pediatric development applied to bilastine: Analysis of the clinical PK data and confirmation of the dose selected for the target population. Eur J Pharm Sci 2018; 128:180-192. [PMID: 30468868 DOI: 10.1016/j.ejps.2018.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/05/2018] [Accepted: 11/15/2018] [Indexed: 01/05/2023]
Abstract
Bilastine is a non-sedating second-generation H1 antihistamine approved for treatment of allergic rhinoconjunctivitis (AR) and urticaria (U) in adults at the oral (p.o.) dose of 20 mg once daily (OD). Optimal attributes can be anticipated for its clinical use in pediatrics due to its favorable safety and tolerability and age-independent PD profile. The aim of this work was to characterize bilastine PK in children through population modeling of data from a limited sampling confirmatory clinical trial in children with AR or U. The objective was also to ascertain whether the proposed dose (10 mg/day) in the target pediatric subset aged 2-<12 years matches the systemic exposure seen in adults at the 20 mg/day dose. A popPK model characterizing bilastine PK behavior in children aged from 4 to <12 years treated with 10 mg oral bilastine daily was successfully developed and qualified. No relationship was found between bilastine PK and age or weight; stopping rules pre-stablished to finalize the trial, i.e., model completeness and no dependence of exposure on decreasing age, were thus fulfilled. On a second step, the popPK model in children was linked to the PD model in adults assuming the same PD as described in adults and used to compare the PD outcome between both populations. Finally, an allometric scaling method and a physiological approximation were used to evaluate the suitability of the selected dose in the youngest children, showing that children from 2 years were deemed to belong to the same population as well. The achievement of comparable PK (i.e., within the range) to that observed in adults after the therapeutic dose of 20 mg, together with the achievement of similar PD and additional integrative analysis, served to confirm the validity of the 10 mg daily dose for the target pediatric subset (2 to <12 years).
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Affiliation(s)
- Valvanera Vozmediano
- Drug Modeling & Consulting, Dynakin, SL, Bilbao, Spain; Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, University of Florida, United States of America.
| | - John C Lukas
- Drug Modeling & Consulting, Dynakin, SL, Bilbao, Spain
| | | | - Stephan Schmidt
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, University of Florida, United States of America
| | - Ander Sologuren
- Clinical Research Department, FAES FARMA, SA, Leioa, Bizkaia, Spain
| | - Román Valiente
- Clinical Research Department, FAES FARMA, SA, Leioa, Bizkaia, Spain
| | - Luis Labeaga
- Clinical Research Department, FAES FARMA, SA, Leioa, Bizkaia, Spain
| | - Cristina Campo
- Clinical Research Department, FAES FARMA, SA, Leioa, Bizkaia, Spain
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Sugita K, Yamamoto O. Hypereosinophilia successfully treated with the novel antihistamine bilastine. Clin Exp Dermatol 2018; 44:586-588. [PMID: 30280422 DOI: 10.1111/ced.13808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- K Sugita
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - O Yamamoto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
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Model Informed Pediatric Development Applied to Bilastine: Ontogenic PK Model Development, Dose Selection for First Time in Children and PK Study Design. Pharm Res 2017; 34:2720-2734. [PMID: 28971281 DOI: 10.1007/s11095-017-2248-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/21/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Bilastine is an H1 antagonist whose pharmacokinetics (PK) and pharmacodynamics (PD) have been resolved in adults with a therapeutic oral dose of 20 mg/day. Bilastine has favorable characteristics for use in pediatrics but the PK/PD and the optimal dose in children had yet to be clinically explored. The purpose is to: (1) Develop an ontogenic predictive model of bilastine PK linked to the PD in adults by integrating current knowledge; (2) Use the model to design a PK study in children; (3) Confirm the selected dose and the study design through the evaluation of model predictability in the first recruited children; (4) Consider for inclusion the group of younger children (< 6 years). METHODS A semi-mechanistic approach was applied to predict bilastine PK in children assuming the same PD as described in adults. The model was used to simulate the time evolution of plasma levels and wheal and flare effects after several doses and design an adaptive PK trial in children that was then confirmed using data from the first recruits by comparing observations with model predictions. RESULTS PK/PD simulations supported the selection of 10 mg/day in 2 to <12 year olds. Results from the first interim analysis confirmed the model predictions and design hence trial continuation. CONCLUSION The model successfully predicted bilastine PK in pediatrics and optimally assisted the selection of the dose and sampling scheme for the trial in children. The selected dose was considered suitable for younger children and the forthcoming safety study in children aged 2 to <12 years.
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Antonijoan R, Coimbra J, García-Gea C, Puntes M, Gich I, Campo C, Valiente R, Labeaga L. Comparative efficacy of bilastine, desloratadine and rupatadine in the suppression of wheal and flare response induced by intradermal histamine in healthy volunteers. Curr Med Res Opin 2017; 33:129-136. [PMID: 27659218 DOI: 10.1080/03007995.2016.1240665] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To compare the peripheral antihistaminic activity of bilastine, rupatadine and desloratadine in inhibiting the histamine-induced wheal and flare (W&F) response. RESEARCH DESIGN AND METHODS Twenty-four healthy volunteers aged 18-40 years participated in this crossover, randomized, double-blind, placebo-controlled clinical study. Subjects received single doses of bilastine 20 mg, desloratadine 5 mg, rupatadine 10 mg and placebo. W&F responses induced by intradermal injection of histamine 5 μg were evaluated before treatment (basal value) and at 0.5, 1, 2, 4, 6, 9, 12 and 24 hours after treatment. Fifteen minutes after histamine injection, W&F surface areas (cm2) were quantified using the Visitrak System. Itching sensation was evaluated using a 100 mm visual analog scale. EudraCT number: 2015-000790-13. MAIN OUTCOME MEASURES The primary outcome measure was the percentage reduction in W&F areas after each active treatment compared with corresponding basal values. RESULTS Bilastine induced the greatest inhibition in wheal area and was significantly superior to desloratadine and rupatadine from 1 to 12 hours (both p < .001). Rupatadine and desloratadine were better than placebo without differences between them. Maximum wheal inhibition occurred at 6 hours (bilastine 83%, desloratadine 38%, rupatadine 37%). Onset of action was 1 hour for bilastine and 4 hours for desloratadine and rupatadine. Bilastine was significantly superior to desloratadine and rupatadine for flare inhibition from 1-24 hours (both p < .001) with an onset of action at 30 minutes. Bilastine was significantly better than desloratadine (2-12 hours; at least p < .05) and rupatadine (2-9 hours; at least p < .01) for reducing itching sensation. Neither desloratadine nor rupatadine significantly reduced itching compared to placebo. All active treatments were well tolerated. CONCLUSIONS Bilastine 20 mg induced significantly greater inhibition of the W&F response compared with desloratadine 5 mg and rupatadine 10 mg throughout the 24 hour study period, and had the fastest onset of action. Only bilastine significantly reduced itching sensation versus placebo.
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Affiliation(s)
- Rosa Antonijoan
- a Drug Research Center (CIM), Biomedical Research Institute Sant Pau (IIB Sant Pau) , Barcelona , Spain
- b Pharmacology and Therapeutics Department , Universitat Autònoma de Barcelona (UAB) , Bellaterra , Spain
| | - Jimena Coimbra
- a Drug Research Center (CIM), Biomedical Research Institute Sant Pau (IIB Sant Pau) , Barcelona , Spain
| | - Consuelo García-Gea
- a Drug Research Center (CIM), Biomedical Research Institute Sant Pau (IIB Sant Pau) , Barcelona , Spain
| | - Montserrat Puntes
- a Drug Research Center (CIM), Biomedical Research Institute Sant Pau (IIB Sant Pau) , Barcelona , Spain
| | - Ignasi Gich
- a Drug Research Center (CIM), Biomedical Research Institute Sant Pau (IIB Sant Pau) , Barcelona , Spain
- b Pharmacology and Therapeutics Department , Universitat Autònoma de Barcelona (UAB) , Bellaterra , Spain
| | - Cristina Campo
- c Clinical Research Department , Faes Farma SA , Leioa , Bizkaia , Spain
| | - Román Valiente
- c Clinical Research Department , Faes Farma SA , Leioa , Bizkaia , Spain
| | - Luis Labeaga
- c Clinical Research Department , Faes Farma SA , Leioa , Bizkaia , Spain
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Ridolo E, Montagni M, Bonzano L, Incorvaia C, Canonica GW. Bilastine: new insight into antihistamine treatment. Clin Mol Allergy 2015; 13:1. [PMID: 25878559 PMCID: PMC4397738 DOI: 10.1186/s12948-015-0008-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 02/19/2015] [Indexed: 11/10/2022] Open
Abstract
Bilastine is a new second generation H1-antihistamine recently approved for the symptomatic treatment of allergic rhinitis (AR) and chronic urticaria (CU). Bilastine epitomizes the evolution of research on antihistamines concerning both efficacy and safety. In AR treatment, a number of large controlled clinical trials documented its efficacy, as assessed by improvement of all nasal and ocular symptoms and quality of life. These outcomes show that bilastine meets current EAACI/ARIA criteria for medications used in the treatment of AR. Also in CU, the review of the literature indicates that once-daily treatment with bilastine 20 mg was effective in managing symptoms and improving patient's quality of life. Concerning safety and tolerability, the profile of bilastine is very similar to placebo and in particular the adverse effects on central nervous system are insignificant. The balance of efficacy and safety of bilastine is particularly helpful when dosages higher than standard are needed to control the symptoms, as frequently occurs in patients with urticaria, in whom antihistamines doses up to four times the standard dose may be administered.
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Affiliation(s)
- Erminia Ridolo
- Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, Parma, 43126 Italy
| | - Marcello Montagni
- Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, Parma, 43126 Italy
| | - Laura Bonzano
- Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, Parma, 43126 Italy
| | | | - Giorgio Walter Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
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