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At the time, however, evidence was already emerging of a broader mechanism of action for rupatadine involving other mediators implicated in the inflammatory cascade. Over the past few years, the role of platelet\u2010activating factor (<jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content>) as a potent mediator involved in the hypersensitivity\u2010type allergic reaction has gained greater recognition. Rupatadine has dual affinity for histamine H<jats:sub>1<\/jats:sub>\u2010receptors and <jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content> receptors. In view of the Allergic Rhinitis and its Impact on Asthma group's call for oral antihistamines to exhibit additive anti\u2010allergic\/anti\u2010inflammatory properties, further exploration of rupatadine's anti\u2010<jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content> effects was a logical step forward. New studies have demonstrated that rupatadine inhibits <jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content> effects in nasal airways and produces a greater reduction in nasal symptoms than levocetirizine. A meta\u2010analysis involving more than 2500 patients has consolidated the clinical evidence for rupatadine in allergic rhinoconjunctivitis in adults and children (level of evidence Ia, recommendation A). Other recent advances include observational studies of rupatadine in everyday clinical practice situations and approval of a new formulation (1\u00a0mg\/ml oral solution) for use in children. In this reappraisal, we revisit some key properties and pivotal clinical studies of rupatadine and examine new clinical data in more detail including studies that measured health\u2010related quality of life and studies that investigated the efficacy and safety of rupatadine in other indications such as acquired cold urticaria, mosquito bite allergy and mastocytosis.<\/jats:p>","DOI":"10.1111\/all.12531","type":"journal-article","created":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T09:59:54Z","timestamp":1418205594000},"page":"1-24","source":"Crossref","is-referenced-by-count":60,"title":["Update on rupatadine in the management of allergic disorders"],"prefix":"10.1111","volume":"70","author":[{"given":"J.","family":"Mullol","sequence":"first","affiliation":[{"name":"Unitat de Rinologia i Cl\u00ednica de l'Olfacte Servei d'ORL Hospital Cl\u00ednic Clinical &amp; Experimental Respiratory Immunoallergy IDIBAPS Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Bousquet","sequence":"additional","affiliation":[{"name":"University H\u00f4pital Arnaud de Villeneuve and INSERM Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bachert","sequence":"additional","affiliation":[{"name":"Department of Oto\u2010Rhino\u2010Laryngology Upper Airway Research Laboratory (URL) Ghent University Hospital Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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