Rupex (rupatadine) / Incepta Pharma, Medexus - LARVOL DELTA

The effects of oral second-generation antihistamines on psychomotor, cognitive, and academic performance: A systematic review (AAAAI 2026) - "Search terms included oral second-generation antihistamines approved for use in the United States and Canada, specifically cetirizine, loratadine, fexofenadine, desloratadine, levocetirizine, bilastine, and rupatadine, with the terms psychomotor, cognitive, and academic performance. Varying effects were found across these categories. Understanding these outcomes will better inform patient care via appropriate selection of antihistamines to minimize disruption on daily activities."

Review • Anesthesia

The dual role of OTUD3 in cancer: mechanisms and therapeutic implications. (PubMed, Cancer Cell Int) - "The development of OTUD3-targeted inhibitors like Rolapitant, Rupatadine, and OTUDin3 shows promise in preclinical models, particularly in combination with immunotherapy. However, its tissue-specific duality poses both challenges and opportunities for therapeutic intervention. Further research is needed to elucidate OTUD3's mechanistic networks and advance its clinical translation as a prognostic biomarker and therapeutic target in precision oncology."

IO biomarker • Journal • Review • Oncology • Ovarian Cancer • Solid Tumor • Targeted Protein Degradation • HSPA5 • PD-L1 • PTEN • YY1

Effectiveness of the antihistamine and anti-PAF effects of rupatadine in allergic diseases: off-label use in a case series study. (PubMed, Drugs Context) - "All these properties have positioned rupatadine as a remarkable treatment option for adults and children with various allergic and skin disorders, including allergic rhinitis and urticaria of different causes. This case series shows the real-world effectiveness and safety of off-label rupatadine use in paediatric patients with clinically relevant complex allergy-related and dermatology-related conditions, whose underlying pathogenetic mechanisms were successfully addressed by the pharmacological profile of rupatadine."

Journal • Allergic Rhinitis • Allergy • Dermatology • Food Hypersensitivity • Immunology • Inflammation • Pediatrics • Urticaria

Effectiveness of antiviral, immunomodulatory and platelet-enhancing agents for treatment of dengue infection: A systematic review. (PubMed, Virulence) - "The platelet-enhancing agents recombinant human IL-11, anti-rhD immunoglobulin (anti-D), and eltrombopag all showed a significant rise in platelet count. Small sample sizes make it challenging to draw definitive conclusions out of the included studies. Larger clinical trials are needed to evaluate treatments for DENV, with particular focus on doxycycline, Carica papaya, rupatadine, and platelet-enhancing agents."

Journal • Review • Dengue Fever • Infectious Disease • IL6

Comparing Antihistamines for Chronic Urticaria: Systematic Review Dose Response and Network Meta-Analysis of Randomized Trials (ACAAI 2025) - "Sedation likely increases with higher doses, with first-generation agents among the most sedating; cetirizine, ketotifen, levocetirizine, and rupatadine among the intermediate sedating; and bilastine, desloratadine, fexofenadine, and loratadine among the least sedating. Cetirizine and loratadine are among the most effective for all components of urticaria activity, but cetirizine is intermediately sedating and loratadine has lower certainty on improving quality of life and sleep. Higher doses may have diminishing benefits and increased risks."

Retrospective data • Review • Anesthesia • Cardiovascular • CNS Disorders • Dermatology • Immunology • Pruritus • Sleep Disorder • Urticaria

Upadacitinib Effective for Dupilumab Refractory Chronic Spontaneous Urticaria: A Case Series Study of 6 Patients (ACAAI 2025) - "No significant improvements were observed in urticaria activity scores (UAS) during treatment using omalizumab and sgAH (cetirizine, rupatadine, or bilastine), with no significant changes in score when switched to dupilumab. Discussion These findings highlight upadacitinib’s potential role in treating severe refractory CSU. Just as we once presented the first case series in dupilumab for CSU, 4 it is our hope that this encourages further development through randomized controlled trials in JAK inhibitors for CSU."

Clinical • Cardiovascular • Chronic Spontaneous Urticaria • Dermatology • Immunology • Urticaria • JAK1

Comparison of Allergic Rhinitis Treatments on Patient Satisfaction: A MASK-air and EAACI Methodological Committee Report. (PubMed, Allergy) - "Using patient-reported data, we evaluated different medication classes and treatments in terms of satisfaction and co-medication frequency. These results provide key insights into the acceptability of AR treatments and will contribute to future treatment guidelines."

Journal • Allergic Rhinitis • Immunology • Inflammation

Rupatadine in Patients With Ulcerative Colitis (clinicaltrials.gov) - P2 | N=60 | Recruiting | Sponsor: Alexandria University | Not yet recruiting ➔ Recruiting

Enrollment open • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Repurposing rupatadine as topical treatment against methicillin-resistant Staphylococcus aureus. (PubMed, AMB Express) - "Three promising non-antibiotic ligands (rupatadine, orlistat, and citric acid) were evaluated through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), molecular docking, cytotoxicity testing, and a murine model of MRSA skin infection...Checkerboard assays revealed synergistic effects between rupatadine and β-lactam antibiotics (cefazolin and cefotaxime, FICI = 0.3)...Functional enrichment and pathway network analyses revealed significant disruption of biological processes governing peptidoglycan biosynthesis and cell wall biogenesis, which indicates the possibility of rupatadine compromising S. aureus cell wall integrity through interference with peptidoglycan assembly pathways, supporting its potential as a repurposed anti-MRSA agent. Rupatadine showed favorable tolerance on human skin fibroblast cells (IC50: 1150 µg/mL), and significantly reduced bacterial count in a murine model."

Journal • Dermatology • Infectious Disease

Not Just Another Eczema: A Rare Pediatric Case of Sulzberger–Garbe Dermatosis (EADV 2025) - "The patient was treated with potent topical corticosteroids (daily 0.05% betamethasone dipropionate, later switched to 0.05% clobetasol propionate in weekend therapy) and oral antihistamines (10 mg rupatadine 1 x daily). This case highlights a rare pediatric manifestation of Sulzberger–Garbe dermatosis. Although classically described in adult males, the condition should also be considered in adolescents with chronic, pruritic dermatoses unresponsive to conventional treatment. Comprehensive differential diagnosis – including allergy screening and histopathologic evaluation – is essential to exclude other dermatoses that share similar clinical features."

Clinical • Atopic Dermatitis • Dermatology • Eosinophilia • Immunology • Pediatrics • Pruritus • CRP

Acute Urticaria in Lyme Disease: A Case Report and Diagnostic Challenge (EADV 2025) - "The patient was prescribed rupatadine 10 mg daily and advised to repeat serological testing via immunoblot after four weeks...Following confirmation of the diagnosis, a standard course of doxycycline was initiated, resulting in complete remission with no further recurrence... This case illustrates that acute urticaria can, in rare circumstances, be the only dermatologic sign of early Lyme borreliosis, even in the absence of classic symptoms or clear exposure history. Timely repeat serologic testing allowed for diagnostic confirmation and the initiation of effective treatment. Our experience highlights the importance of maintaining a broad differential diagnosis in patients with atypical or treatment-resistant urticaria, and considering Lyme disease as a potential underlying cause."

Case report • Clinical • Dermatitis • Dermatology • Immunology • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Urticaria

Olopatadine vs. Rupatadine for Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials. (PubMed, Cureus) - "Olopatadine showed greater efficacy in reducing symptoms of allergic rhinitis compared to rupatadine, while both drugs had similar safety profiles. These findings suggest that olopatadine may be preferred for more symptom relief, though larger trials are needed for further validation."

Journal • Retrospective data • Review • Allergic Rhinitis • Anesthesia • Immunology • Inflammation • Pain • Xerostomia

Repurposing rupatadine to attenuate ovarian ischemia reperfusion in rats through modulation of PAF/NF-κB/TNF-α/IL-1β; HIF-1α/VEGF/Caspase 3 signaling pathways. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "While, OIR + RUP pretreated group showed a reversal in OIR damaging effects in a significant manner in all the aforementioned parameters. Based on these findings; RUP has powerful anti-IR actions by lowering oxidative stress, inflammation, and apoptosis via modulation of the PAF/ NF-κB/TNF-α/ IL-1β; HIF-1α/ VEGF / Caspase 3 signaling pathways."

Journal • Preclinical • Cardiovascular • Oncology • Reperfusion Injury • CASP3 • HIF1A • IL1B • TNFA

Rupatadine in Patients With Ulcerative Colitis (clinicaltrials.gov) - P2 | N=60 | Not yet recruiting | Sponsor: Alexandria University

New P2 trial • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Phenotypic Screening of H1-Antihistamines Identifies Promethazine and Rupatadine as Active Compounds Against Toxocara canis Infective Larvae. (PubMed, Pharmaceuticals (Basel)) - " Promethazine and rupatadine exhibited significant larvicidal effects, surpassing albendazole in reducing larval motility and inducing a distinct contorted morphology not observed in control or albendazole-treated larvae. Docking studies revealed favorable binding to the colchicine site of T. canis β-tubulin. This is the first report of larvicidal activity of antihistamines against T. canis, supporting their potential as repurposed therapeutic agents for the treatment of zoonotic helminthiases, particularly those caused by tissue-migrating nematodes."

Journal • Infectious Disease

Rupatadine modulates TLR4/MYD88/NF-κB and AKT/PI3K signaling pathways, attenuating sepsis-induced liver injury in mice. (PubMed, Eur J Pharmacol) - "RUP may be considered a novel therapeutic agent in sepsis-related liver injury pending further clinical studies."

IO biomarker • Journal • Preclinical • Hepatology • Infectious Disease • Inflammation • Liver Failure • Septic Shock • IL6 • MYD88 • TLR4

When Antihistamines Trigger Allergies: A Case of Hydroxyzine Allergy (EAACI 2025) - "PT with alternative antihistamines (cetirizine 10 mg 10% pet; levocetirizine 5 mg 10% pet, clemastine 1 mg 10% pet; loratadine 10 mg 10% pet, desloratadine 5 mg 10% pet, ebastine 20 mg 10% pet, bilastine 20 mg 10% pet, rupatadine 10 mg 10% pet; fexofenadine 120 mg 10% pet and dimetindene 1mg/ml) were all negative. HR to hydroxyzine was confirmed, and its avoidance recommended. Dimetindene was well tolerated and approved for use. Data on antihistamine cross-reactivity (CR) is limited."

Clinical • Allergy • Dermatitis • Immunology • Psoriasis

Application of Desensitization Protocol with Rituximab in the Treatment of Corticosteroid-Dependent Nephrotic Syndrome in an Adolescent (EAACI 2025) - "Two days later, she was re-administered rituximab following a desensitization protocol, which included: • Pre-treatment with rupatadine, prednisone, paracetamol orally (due to potential headache as adverse reaction) and dimethindene intravenously, 30 minutes prior to the infusion. Results The rituximab session was completed without complications, following the desensitization protocol. Conclusion The use of desensitization protocols for rituximab may serve as an important tool in managing corticosteroid-dependent nephrotic syndrome in children, as it allows the patient to benefit from the therapeutic benefits of the drug without allergic reactions and provides a solution to the therapeutic dilemma faced by the treating physician."

Clinical • Late-breaking abstract • Immunology • Rheumatology

Rupatadine treatment improves disease control in patients with chronic spontaneous urticaria – results from the CURE registry (EAACI 2025) - "Baseline treatment included sgAH at licensed doses (44.9%), sgAH updosed (35.7%), omalizumab at licensed doses (8.9%), omalizumab at high dose (1%), ciclosporin (0.6%) and other therapies (9.7%). Conclusion In this real-world setting, most patients were treated with sgAH, consistent with international guideline recommendations. Rupatadine treatment proved to be an effective option for managing CSU."

Clinical • Late-breaking abstract • Immunology

Successful Management of Primary Cold Urticaria in Medical Practitioners: A Small Case Series (EAACI 2025) - "Primary management includes trigger avoidance and regular use of antihistamines (often ineffective), while off-label administration of omalizumab is the recommended second line of treatment...Full response was achieved with two tablets of 10 mg rupatadine daily...Initial treatment with four 5 mg levocetirizine tablets daily caused adverse events (drowsiness, tiredness)...Daily 5 mg desloratadine was prescribed, achieving symptom remission, and treatment was later adjusted to as-needed antihistamines...Establishing a link between TempTest thresholds and antihistamine response could guide dosing in clinical practice. Further research on larger cohorts might uncover trends, helping refine personalized antihistamine dosing strategies."

Clinical • Immunology • Rheumatology

Use of ketotifen as treatment for post viral infection cough in children (EAACI 2025) - "At visit 2, having confirmed that there were no more symptoms of florid infection or asthma, a discussion occurred with the parents regarding cough management options including the pros and cons of prescribing ketotifen or SGAHs (loratadine/desloratadine, cetirizine/levocetirizine, bilastine, rupatadine) at approved doses. SGAH have advantages however based on less sedation and adverse effects. The choice between ketotifen and SGAH for post viral cough should be guided by the patient's specific symptoms, underlying conditions, and overall treatment goals."

Clinical • Immunology

The prevalence and management features of adolescents with atopic dermatitis under humanitarian crisis (EAACI 2025) - "Additionally, patients received rupatadine fumarate (10 mg) and the glycine (0.25 g, twice daily) Results PTSD was diagnosed in 202 (79.5%) patients (median score: 18 [9; 24]), among whom AD was present in 32 (15.8%) individuals, with 40.6% being girls and 59.4% boys...Conclusion Under humanitarian crisis conditions, adolescents with PTSD demonstrate a high prevalence of AD with a moderate severity course. Managing such patients requires targeted diagnosis of stress disorders, the addition of antihistamines and sedatives to traditional AD therapy, and collaboration with qualified psychologists and psychotherapists."

Atopic Dermatitis • Dermatitis • Immunology

Modulating platelet-activating factor by rupatadine attenuates gentamicin-induced nephrotoxicity in rats via NF-κB/caspase-3 and Nrf2/HO-1 signaling cascades. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "RUP suppressed the levels of the proinflammatory mediators, inactivated the renal NF-κB and caspase 3 proteins, declined renal mRNA levels of Bax gene, and upregulated the renal mRNA level of the Bcl-2 gene. In conclusion, RUP mitigated GEN-caused renal damage by suppressing proinflammatory markers, mitigating apoptosis via repressing the intracellular PAF/NF-κB/caspase-3 pathway and upregulating Nrf2/HO-1 signaling cascades."

IO biomarker • Journal • Preclinical • Infectious Disease • Renal Disease • BAX • BCL2 • CASP3 • CAT • CST3 • IL1B • TNFA

Pharmacokinetics and Safety of Rupatadine in Participants With Hepatic Impairment Compared to Control Participants. (clinicaltrials.gov) - P1 | N=26 | Completed | Sponsor: Noucor Health S.A. | Recruiting ➔ Completed | N=44 ➔ 26 | Trial completion date: Dec 2024 ➔ Apr 2025 | Trial primary completion date: Dec 2024 ➔ Apr 2025

Enrollment change • Trial completion • Trial completion date • Trial primary completion date • Hepatology

Pharmacokinetics and Safety of Rupatadine in Participants With Renal Impairment Compared to Control Participants (clinicaltrials.gov) - P1 | N=48 | Recruiting | Sponsor: Noucor Health S.A. | Trial completion date: Dec 2024 ➔ Jul 2025 | Trial primary completion date: Dec 2024 ➔ Jul 2025

Trial completion date • Trial primary completion date • Renal Disease