Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis

奥马佐单抗 医学 荟萃分析 不利影响 安慰剂 随机对照试验 严格标准化平均差 内科学 生活质量(医疗保健) 最小临床重要差异 系统回顾 免疫球蛋白E 人口 梅德林 免疫学 抗体 替代医学 病理 护理部 法学 环境卫生 政治学
作者
Sophia Tsabouri,George Ntritsos,Fotios Koskeridis,Εvangelos Εvangelou,Petter Olsson,Κonstantinos Κostikas
出处
期刊:Rhinology [European Rhinologic Society]
被引量:26
标识
DOI:10.4193/rhin21.159
摘要

Background: Allergic rhinitis (AR), an IgE mediated inflammatory disease, significantly impacts quality of life of a considerable proportion of the general population. Omalizumab, a humanized monoclonal antibody against IgE, has been evaluated for both seasonal and perennial AR. We aimed to assess the efficacy and safety of omalizumab in randomized controlled trials (RCTs) in inadequately controlled AR. Methods: We conducted a systematic literature search of RCTs evaluating the safety and efficacy of omalizumab in AR. We synthesized evidence for clinical improvement of AR symptoms, quality of life, reduction of the use of rescue medication, and adverse events. Results: The systematic search returned 289 articles, of which 12 RCTs were eligible for data extraction and meta-analysis. Omalizumab reduced the Daily Nasal Symptom Severity Score (DNSSS) by a summary standardized mean difference of -0.41 points with large heterogeneity; omalizumab significantly reduced the DNSSS both in the 3 cedar pollen-induced AR trials by -0.97 points and to a lower extent in the remaining five non-cedar trials by -0.19 points. Omalizumab also improved the Daily Ocular Symptom Severity Score (DOSSS) by a summary standardized mean difference of -0.30 points with large heterogeneity; the Rhino-conjunctivitis Quality of Life Questionnaire by a summary standardized mean difference of -0.45 points with no heterogeneity and the mean daily consumption of rescue antihistamines by a summary standardized mean difference of -0.21 with large heterogeneity. No statistically significant difference in the occurrence of adverse events was observed between omalizumab and placebo. Conclusion: Our findings further support the efficacy and safety of omalizumab in the management of patients with allergic rhinitis inadequately controlled with a conventional treatment.
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