Olopatadine is Better Treatment Option for CIU than Rupatadine

September 18, 2020
Jonathan Alicea

Both antihistamines are indicated for treatment of chronic idiopathic urticaria, yet olopatadine demonstrates better clinical improvements and fewer adverse events.

New data demonstrated olopatadine to have a superior efficiency and safety profile to rupatadine for treatment of chronic idiopathic urticaria in adult patients.

Both antihistamines have been indicated in treating urticaria of idiopathic origin as result of their known efficiency and safety, but a recent study sought to compare the drugs to determine which proved to be a better choice for treatment.

The investigators enrolled a total of 60 patients with chronic idiopathic urticaria from the Department of Dermatology at Prathima Institute of Medical Sciences in Karimnagar, India. The population included both male and female that represented ages between 18-70 years.

All patients experienced urticarial episodes 3 times a week for at least 4 consecutive weeks and exhibited no detectable causes.

At the outset of the study, the patients were divided 1:1 to receive orally either olopatadine or rupatadine with a dosing schedule of 10 mg daily for 4 weeks.

Each patient was then assessed for the degree of urticarial pruritus, size of urticarial wheals, number of the urticarial wheals, and number of isolated urticarial episodes. The investigators rated the severity of each symptom on a scale from 1-3, thus allowing for a total composite total symptom score of 12.

As baseline, the mean total symptom score for those assigned to olopatadine was 7.58. For those in the rupatadine group, mean total score was 7.63. 

In addition to total symptom score, the parameters used to evaluate clinical improvement were change in absolute eosinophil count and IgE level.

Baseline absolute eosinophil count for the olopatadine and rupatadine groups, respectively, were 683.92 and 672.70. 

Serum IgE levels were 347.6 for olopatadine and 284.53 for rupatadine.

By the start of the follow-up period, 51 patients had completed the study — 5 and 4 patients were lost in the olopatadine and rupatadine groups, respectively.

Data analysis was done using a paired t test, unpaired t test, and Fisher’s exact test.

The investigators reported that the mean reduction in total symptom score for those who had received olopatadine was 3, versus a reduction of 2 in those who received rupatadine.

Furthermore, the mean change in absolute eosinophil count for the olopatadine group was 320—as compared with 188 for the rupatadine group (P = .001). 

The mean changes in serum IgE levels for both antihistamines were 104 and 57, favoring olopatadine (P = .003).

Absolute eosinophil count was also found to have a strong positive association with total symptom score (coefficient of correlation = 0.482, P<.001).

In terms of safety profile, both drugs were well tolerated and presented no new adverse events. The event rate was 20% in olopatadine and 23.07% in rupatadine, with the most common effects between the groups being gastric irritation, drowsiness, headache, and dryness of mouth.

Therefore, the investigators concluded that the results suggest olopatadine to be a safer and more efficient treatment choice in addressing chronic idiopathic urticaria.

The study, “The Efficiency and Safety of Olopatadine against Rupatadine in Chronic Urticaria of Idiopathic Origin: A Comparative Study,” was published online in Biomedical and Pharmacology Journal.


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