{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:24:09Z","timestamp":1790270649840,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,6,6]],"date-time":"2013-06-06T00:00:00Z","timestamp":1370476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cold contact urticaria (<jats:styled-content style=\"fixed-case\">CCU<\/jats:styled-content>) is characterized by itchy wheal and flare responses due to the release of histamine and other pro\u2010inflammatory mediators after exposure to cold. The treatment of choice is nonsedating antihistamines, dosages of which may be increased up to fourfold if standard doses are ineffective. Here, we assess the effects of a standard 20\u00a0mg dose and up\u2010dosing to 40 and 80\u00a0mg of bilastine in reducing the symptoms of <jats:styled-content style=\"fixed-case\">CCU<\/jats:styled-content> and inflammatory mediator release following cold challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty patients with <jats:styled-content style=\"fixed-case\">CCU<\/jats:styled-content> were included in this randomized, crossover, double\u2010blind, placebo\u2010controlled 12\u2010week study. They received placebo, 20, 40 or 80\u00a0mg of bilastine daily each for 7\u00a0days with 14\u2010day washout periods. The primary readout was change in critical temperature thresholds (<jats:styled-content style=\"fixed-case\">CTT<\/jats:styled-content>). Secondary readouts were changes in pruritus, levels of histamine <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20106, <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20108 and <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 collected by skin microdialysis and safety and tolerability of bilastine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bilastine 20\u00a0mg was highly effective (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001) in reducing <jats:styled-content style=\"fixed-case\">CTT<\/jats:styled-content>. Up\u2010dosing to 80\u00a0mg significantly (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.04) increased its effectiveness. At this dose, 19 of 20 (95%) patients responded to treatment, with 12 of 20 (60%) becoming symptom free. Only one patient was refractory to treatment. Microdialysis levels of histamine, <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20106 and <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20108 assessed 1\u20133\u00a0h after cold challenge were significantly (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.05) decreased following up\u2010dosing with 80\u00a0mg bilastine. Bilastine treat\u2010ment was well tolerated without evidence of increased sedation with dose escala\u2010tion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bilastine was effective in reducing the symptoms of patients with <jats:styled-content style=\"fixed-case\">CCU<\/jats:styled-content>. Increased efficacy of bilastine with fourfold up\u2010dosing was without sedation and supports urticaria treatment guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12171","type":"journal-article","created":{"date-parts":[[2013,6,6]],"date-time":"2013-06-06T13:37:14Z","timestamp":1370525834000},"page":"921-928","source":"Crossref","is-referenced-by-count":108,"title":["Up\u2010dosing with bilastine results in improved effectiveness in cold contact urticaria"],"prefix":"10.1111","volume":"68","author":[{"given":"K.","family":"Krause","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy Allergie\u2010Centrum\u2010Charit\u00e9 Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Spohr","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Allergie\u2010Centrum\u2010Charit\u00e9 Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Zuberbier","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Allergie\u2010Centrum\u2010Charit\u00e9 Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. K.","family":"Church","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Allergie\u2010Centrum\u2010Charit\u00e9 Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Allergie\u2010Centrum\u2010Charit\u00e9 Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin 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