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

"Green spectrophotometric determination of rupatadine, its toxic impurity, and methyl paraben: comparative AI-assisted univariate versus multivariate chemometrics". (PubMed, Sci Rep) - "Sensitive and selective green UV-spectrophotometric univariate and multivariate chemometric methods were developed to resolve the overlapped spectra of rupatadine fumarate (RUP), its impurity desloratadine (DES), and methyl paraben (MP). The results obtained were reliable and reproducible, confirming the suitability of these methods for routine analysis and quality control in laboratories. Moreover, the GLANCE tool (Graphical Layout for Analytical Chemistry Evaluation) offered a clear visual summary of the twelve structured method attributes."

Clinical • Journal

Rupatifen Fumarate Capsules in Patients With Seasonal Allergic Rhinitis (clinicaltrials.gov) - P3 | N=550 | Recruiting | Sponsor: Fujian Mindong Rejuvenation Pharmaceutical Co., Ltd. | Not yet recruiting ➔ Recruiting

Enrollment open • Allergic Rhinitis • Immunology • Inflammation

Second-generation H1 antihistamines for the treatment of chronic urticaria: a network meta-analysis. (PubMed, Front Med (Lausanne)) - "To evaluate the efficacy and safety of 10 commonly used second-generation H1 antihistamines (cetirizine, levocetirizine, loratadine, desloratadine, ebastine, bilastine, olopatadine, rupatadine, fexofenadine, and mizolastine) at licensed doses in treating chronic urticaria using network meta-analysis. In addition, fexofenadine had the lowest incidence of adverse reactions. However, the conclusions of this study still need to be validated by further high-quality randomized controlled trials."

Journal • Retrospective data • Review • Chronic Spontaneous Urticaria • Dermatology • Immunology • Urticaria

Rupatadine Ameliorates Cisplatin-Induced Hepatotoxicity in Rats: Targeting HMGB1/TLR4/NF-κB and NLRP3/Caspase-1 Signaling Pathways. (PubMed, J Biochem Mol Toxicol) - "On the contrary, pretreatment with either RUPA.3 or RUPA.6 dramatically ameliorated these alterations triggered by CISP injection. RUPA counteracts hepatotoxicity evoked by CISP in rats via its anti-oxidative as well as anti-inflammatory properties via repression of hepatic HMGB1/TLR4/NF-κB and thus restricts the activation of NLRP3/caspase-1 signaling cascade."

Journal • Preclinical • Oncology • HMGB1 • IL10 • IL18 • IL1B • IL6 • NLRP3 • TLR4 • TNFA

Rupatifen Fumarate Capsules in Patients With Seasonal Allergic Rhinitis (clinicaltrials.gov) - P3 | N=550 | Not yet recruiting | Sponsor: Fujian Mindong Rejuvenation Pharmaceutical Co., Ltd.

New P3 trial • Allergic Rhinitis • Immunology • Inflammation

Efficacy and safety of rupatadine in allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials. (PubMed, Ann Med Surg (Lond)) - "Rupatadine is an effective, well-tolerated therapy for AR, providing significant relief from key nasal symptoms, particularly at higher doses. Although quality-of-life benefits were modest, the findings support rupatadine's role as a safe and potent antihistamine option, warranting further long-term and real-world evaluation."

Journal • Retrospective data • Allergic Rhinitis • Immunology • Inflammation

Mechanistic constraints in dengue severity: a systematic review with evidence stratification and agent-based evaluation of logical sufficiency. (PubMed, Front Immunol) - "Two null randomized trials imposed C0 restrictions: rupatadine did not significantly reduce plasma leakage (RR = 0.68, 95% CI 0.41-1.12), and oseltamivir did not improve time to defervescence (MD =+ 0.1 days, p=0.055). It does not establish causal mechanistic validation, molecular equivalence, or patient-level prediction. Claim escalation now requires longitudinal cohorts measuring NS1/viraemia, endothelial barrier injury markers such as SDC1 or Ang-2, and myeloid effector proxies such as sTREM-1 or CXCL10, together with orthogonal functional perturbation assays reporting CI-bearing outcomes."

Journal • Review • Dengue Fever • Hematological Disorders • Thrombocytopenia • CXCL10 • SDC1

Basophil Testing Beyond Positivity: Are There More Endotypes in Chronic Spontaneous Urticaria? (EAACI 2026) - "Case description: We report a 34-year-old woman with severe CSU characterized by daily wheals and recurrent facial angioedema, refractory to multiple second-generation H1-antihistamines (loratadine, levocetirizine, bilastine and rupatadine) at up to fourfold doses, as well as montelukast 10 mg...Given severe corticosteroid-dependent CSU refractory to high-dose antihistamines, omalizumab was initiated, leading to rapid clinical improvement, complete corticosteroid withdrawal and sustained disease control after one month. Despite severe, treatment-refractory disease, the absence of serum-induced basophil activation argues against classical type IIb autoimmune CSU. Detailed basophil phenotyping revealed increased basal activation, highlighting the limitations of a binary BAT interpretation and supporting the existence of additional, incompletely characterized CSU endotypes."

Late-breaking abstract • Immunology • Inflammation • CD69

Rupatadine inhibits Platelet-Activating Factor-induced Prostaglandin D2 in Nasal Polyps from CRSwNP patients (EAACI 2026) - "Conclusion PAF stimulated PGD₂ secretion from human nasal epithelial cells, this effect being inhibited by rupatadine. This finding reinforces the dual anti-inflammatory activity of rupatadine on sinonasal inflammation."

Clinical • Allergic Rhinitis • Immunology • Inflammation

Multiple Hypersensitivity Reactions to Chemically Unrelated H1 Antihistamines: Two Case Reports (EAACI 2026) - "During subsequent diagnostic work-up, double-blindplacebo-controlled provocation tests (DBPC) were performed with levocetirizine (10mg), fexofenadine (180 mg), desloratadine (5 mg), and bilastine (20 mg)...Subsequently, a provocation test with rupatadine (cumulativedose 10 mg) was performed... The presented cases confirm the possibility of paradoxical hypersensitivity reactionsto antihistamines. To the best of our knowledge, this is the first report describinghypersensitivity reactions to multiple H1 antihistamines with different chemicalstructures."

Case report • Clinical • Immunology

The paradox of treatment: H1-antihistamines-induced urticaria in a patient with chronic spontaneous urticaria (EAACI 2026) - "She was also suffering from allergic rhinitis due to the pollen allergy and had a history of hypersensitivity cutaneous reaction to ibuprofen...Urticaria exacerbations were caused by multiple antihistamines, including piperidine (rupatadine) and piperazine (cetirizine and levocetirizine) derivatives... Although uncommon, antihistamine-induced urticaria in CSU patients may occur and must not be underestimated. Considering the proposed pathogenic hypotheses, patients with an atopic background and a history of cross-reactivity to nonsteroidal anti-inflammatory drugs may be at an increased risk."

Clinical • Allergic Rhinitis • Allergy • Immunology • Inflammation

Bilastine fast onset and strong peripheral antihistaminic activity: comparison with oral second-generation antihistamines and intramuscular dexchlorpheniramine in histamine-induced wheal and flare models (EAACI 2026) - "Comparators included cetirizine, desloratadine, rupatadine, and intramuscular dexchlorpheniramine. Conclusion Across controlled PD studies, bilastine consistently demonstrates a fast onset of action, a strong and sustained antihistaminic activity, and an early itching relief, with a favourable safety profile and preserved efficacy under fed conditions. These findings support the first-line use of bilastine as a fast-acting and efficient antihistamine for the management of allergic diseases requiring rapid symptom control."

Immunology

Delayed hypersensitivity reaction to cetirizine suggesting involvement of piperazine ring: a case report. (PubMed, Allergol Immunopathol (Madr)) - "Importantly, oral provocation with ciprofloxacin, which also contains a piperazine ring, elicited a similar reaction, supporting that this structural moiety itself was responsible for hypersensitivity. Alternatively, AHs lacking the piperazine ring, such as in bilastine and rupatadine, were well tolerated. This case provides the first direct evidence of delayed hypersensitivity manifesting as a maculopapular drug eruption, probably because of the piperazine ring, with cross-reactivity observed between structurally unrelated drugs. Clinicians should be aware of the potential for structural moiety-driven hypersensitivity to prevent recurrence across different drug classes."

Journal • Atopic Dermatitis • Dermatitis • Dermatology • Immunology

Rupatadine as an Add-On Therapy for Dengue Hemorrhagic Fever: A Case Report. (PubMed, Cureus) - "In summary, rupatadine as an add-on therapy to conventional therapy could reduce the risk of complications in DHF. This off-label use of rupatadine needs to be explored in larger studies."

Journal • Dengue Fever • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Pain • Respiratory Diseases • Thrombocytopenia

A red-eye presentation concerning for vernal keratoconjunctivitis: a case report. (PubMed, Allergy Asthma Clin Immunol) - "VKC is uncommon in Canada, but may lead to vision-threatening complications if a patient is not appropriately seen by an ophthalmologist and it goes unrecognized. It should be considered in cases of conjunctivitis that are unresponsive to antihistamines, even when seasonal patterns or allergen sensitization are unclear. Topical and oral antihistamine combination is effective in stabilizing VKC symptoms, with the addition of topical steroids if needed for flares. VKC treatment can require a prolonged course."

Journal • Allergy • Conjunctivitis • Dermatology • Dry Eye Disease • Immunology • Inflammation • Ocular Infections • Ocular Inflammation • Ophthalmology • Pruritus

Exploring the binding interaction of rupatadine with bovine serum albumin using multi-spectroscopic and molecular modeling approaches. (PubMed, BMC Chem) - "The negative values of Gibbs free energy change (ΔG) indicate that the binding process between RUPA and BSA was spontaneous. Furthermore, results of the site marker technique and synchronous fluorescence measurements indicate that RUPA binding interaction occurs at site (I) on BSA in the vicinity of tryptophan residues, which was then confirmed by MD."

Journal • Allergy • Immunology

Management Strategy for Anaphylaxis in a Patient With Suspected or Confirmed Mastocytosis: A Case Report. (PubMed, Am J Case Rep) - "As part of supportive treatment, antihistamines (rupatadine via a nasogastric tube) and intravenous glucocorticosteroids were given. In such patients, intravenous infusion of sodium bicarbonate can be necessary. Therefore, patients with mastocytosis who experience anaphylaxis may be less responsive to epinephrine and should be admitted to the intensive care unit early."

Journal • Critical care • Immunology • Metabolic Disorders • Respiratory Diseases

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

Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis. (PubMed, J Allergy Clin Immunol Pract) - "Although some OAH seem to be more efficacious than others, most differences between individual second-generation medications are trivial or small. In addition, we did not find relevant differences in the safety profiles of second-generation OAH."

Journal • Retrospective data • Allergic Rhinitis • Conjunctivitis • Immunology • Inflammation • Ocular Infections • Ocular Inflammation • Ophthalmology

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