The efficacy of ebastine in the treatment of urticaria Review article
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Abstract
Urticaria is a common dermatological condition characterized by the occurrence of urticarial wheals and/or angioedema. It can be classified as acute (lasting up to 6 weeks) or chronic (lasting more than 6 weeks), which may be spontaneous or induced by various stimuli. The pathophysiology of urticaria is mainly based on the release of histamine from mast cells and basophils, leading to clinical symptoms. Ebastine is a second-generation antihistamine, a selective H1 receptor antagonist that exhibits multidirectional anti-inflammatory properties. In addition to blocking histamine receptors, it inhibits the release of prostaglandins, leukotrienes, and proinflammatory cytokines. After oral administration, it is rapidly metabolized to carebastine, an active metabolite with a long half-life, allowing for once-daily dosing. The efficacy of ebastine has been confirmed in various forms of urticaria. In chronic spontaneous urticaria, which accounts for 80–90% of all chronic urticaria cases, ebastine at a dose of 10 mg significantly reduces itching and the number and size of wheals. Clinical efficacy is maintained long-term without the development of tachyphylaxis. In patients with insufficient response to standard doses, increasing the dose to 20 mg or 40 mg improves symptom control. The drug also shows efficacy in dermographic urticaria, cold urticaria, and acute urticaria. It has a favorable safety profile, minimal impact on the central nervous system, and no cardiotoxic effects even at increased doses. The most common side effects are headache, drowsiness, and dry mouth. A practical advantage of ebastine is its availability in the form of fast-dissolving tablets, which are preferred by patients.
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