Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Meta-analysis
-
Shuai Fu
,
Jiguang Lu
,
Qinwen Zhu
,
Bin Yang
,
Zhiwei Liu
,
Xinyan Liu
,
Jinglin Tian
Abstract
This meta-analysis was conducted to investigate the efficacy and safety of omalizumab in the treatment of allergic rhinitis in adults.
Randomized controlled trials (RCTs) on omalizumab in the treatment of allergic rhinitis in adults were collected by searching PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, and Wanfang Data. The search period was from the establishment of each database to October 2024. Stata 15.0 software was used for data analysis. The control group received a placebo or other anti-allergy drugs, while the experimental group received omalizumab, with or without specific immunotherapy.
A total of 8 RCTs were involved in this meta-analysis. The combined analysis exhibited that the effective rate was higher in the omalizumab group than in the control group (RR=1.15; 95% CI, 1.06–1.24) for allergic rhinitis. IgE levels (SMD=−2.82; 95% CI, −4.03 to −1.62) and DNSS (SMD=−1.99; 95% CI, −3.04 to −0.94), DOSS (SMD=−2.95; 95% CI, −4.65 to −1.25) were lower in the omalizumab group compared with the control group. No significant difference was observed in the incidence of adverse events between the two groups (RR=1.15; 95% CI, 0.69–1.93).
Omalizumab is effective and safe in the treatment of adult allergic rhinitis.
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2. Bernstein JA, Bernstein JS, Makol R, Ward S. Allergic Rhinitis: A Review. Jama-J Am Med Assoc. 2024;331(10):866-77.
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5. Rodrigues J, Pinto JV, Alexandre PL, Sousa-Pinto B, Pereira AM, Raemdonck K, et al. Allergic Rhinitis Seasonality, Severity, and Disease Control Influence Anxiety and Depression. The Laryngoscope. 2023;133(6):1321-7.
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7. Gon Y, Maruoka S, Mizumura K. Omalizumab and IgE in the Control of Severe Allergic Asthma. Front Pharmacol. 2022;13:839011.
8. Shankar T, Petrov AA. Omalizumab and hypersensitivity reactions. Curr Opin Allergy Cl. 2013;13(1):19-24.
9. Liao J, Tang J, Jiang Y, Wang Y, Ding J, He Y. Effects of omalizumab on lung function in patients with moderate-to-severe allergic asthma: a systematic review and meta-analysis. Ther Adv Respir Dis. 2024;18:17534666231221771.
10. Lang D, Liu Z, Li D. Safety and Tolerability of Omalizumab in Children with Allergic (IgE-Mediated) Asthma: A Systematic Review and Meta-Analysis. Discov Med. 2023;35(176):233-41.
11. Wu Q, Zhang Y, Kong W, Wang X, Yuan L, Zheng R, et al. Which Is the Best Biologic for Nasal Polyps: Dupilumab, Omalizumab, or Mepolizumab? A Network Meta-Analysis. Int Arch Allergy Imm. 2022;183(3):279-88.
12. Yu C, Wang K, Cui X, Lu L, Dong J, Wang M, et al. Clinical Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Am J Rhinol Allergy. 2020;34(2):196-208.
13. Tsabouri S, Ntritsos G, Koskeridis F, Evangelou E, Olsson P, Kostikas K. Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis. Rhinology. 2021;59(6):501-10.
14. Casale TB, Bernstein IL, Busse WW, LaForce CF, Tinkelman DG, Stoltz RR, et al. Use of an anti-IgE humanized monoclonal antibody in ragweed-induced allergic rhinitis. J Allergy Clin Immun. 1997;100(1):110-21.
15. Plewako H, Arvidsson M, Petruson K, Oancea I, Holmberg K, Adelroth E, et al. The effect of omalizumab on nasal allergic inflammation. J Allergy Clin Immun. 2002;110(1):68-71.
16. Casale TB, Busse WW, Kline JN, Ballas ZK, Moss MH, Townley RG, et al. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immun. 2006;117(1):134-40.
17. Okubo K, Ogino S, Nagakura T, Ishikawa T. Omalizumab is effective and safe in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Allergol Int. 2006;55(4):379-86.
18. Nagakura T, Ogino S, Okubo K, Sato N, Takahashi M, Ishikawa T. Omalizumab is more effective than suplatast tosilate in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology. 2008;38(2):329-37.
19. Qi ZJ, Li HY, Wang T, Li F. Curative Efficacy of Omalizumab Combined with Budesonide in the Treatment of Allergic Rhinitis and Its Effects on the Peripheral Eosinophil Count and Serum IgE. Lab Immun Clin Med. 2021;28(12):2039-44.
20. Chang YJ, Zhang XL, Mao Y, Cheng YS. Efficacy of omalizumab combined with budesonide spray in the treatment of allergic rhinitis and its effect on the levels of neuropeptide in nasal seretions and serum immune inflammatory indexes. Journal of Clinical and Experimental Medicine. 2024;23(5):539-43.
21. Di Y, Yang YQ, Qi ZY, Li CJ, Fu ZQ. Application Value of Omalizumab on Patients with Allergic Rhinitis Based on Changes of Serum IgE Level and Olfactory Function. Progress in Modern Biomedicine. 2024;24(5):966-70.
22. Zhang Y, Xi L, Gao Y, Huang Y, Cao F, Xiong W, et al. Omalizumab is effective in the preseasonal treatment of seasonal allergic rhinitis. Clin Transl Allergy. 2022;12(1):e12094.
23. Cavaliere C, Begvarfaj E, Incorvaia C, Sposato B, Brunori M, Ciofalo A, et al. Long-term omalizumab efficacy in allergic rhinitis. Immunol Lett. 2020;227:81-7.
24. Gatta A, Della Valle L, Farinelli A, Cavallucci E, Paganelli R, Di Gioacchino M. Omalizumab in chronic spontaneous urticaria: steroid sparing effect. The Journal of Dermatological Treatment. 2018;29(sup3):6-9.
25. Mostafa BE, Fadel M, Mohammed MA, Hamdi TAH, Askoura AM. Omalizumab versus intranasal steroids in the post-operative management of patients with allergic fungal rhinosinusitis. European Archives of Oto-Rhino-Laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2020;277(1):121-8.
26. Liour SS, Tom A, Chan Y, Chang TW. Treating IgE-mediated diseases via targeting IgE-expressing B cells using an anti-CεmX antibody. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology. 2016;27(5):446-51.
27. Galvão VR, Castells MC. Hypersensitivity to biological agents-updated diagnosis, management, and treatment. The Journal of Allergy and Clinical Immunology. In Practice. 2015;3(2):175-86.
28. Kopp MV. Omalizumab: Anti-IgE therapy in allergy. Curr Allergy Asthm R. 2011;11(2):101-6.
2. Bernstein JA, Bernstein JS, Makol R, Ward S. Allergic Rhinitis: A Review. Jama-J Am Med Assoc. 2024;331(10):866-77.
3. Ozdoganoglu T, Songu M. The burden of allergic rhinitis and asthma. Ther Adv Respir Dis. 2012;6(1):11-23.
4. Liu J, Zhang X, Zhao Y, Wang Y. The association between allergic rhinitis and sleep: A systematic review and meta-analysis of observational studies. Plos One. 2020;15(2):e0228533.
5. Rodrigues J, Pinto JV, Alexandre PL, Sousa-Pinto B, Pereira AM, Raemdonck K, et al. Allergic Rhinitis Seasonality, Severity, and Disease Control Influence Anxiety and Depression. The Laryngoscope. 2023;133(6):1321-7.
6. Bernstein DI, Schwartz G, Bernstein JA. Allergic Rhinitis: Mechanisms and Treatment. Immunol Allergy Clin. 2016;36(2):261-78.
7. Gon Y, Maruoka S, Mizumura K. Omalizumab and IgE in the Control of Severe Allergic Asthma. Front Pharmacol. 2022;13:839011.
8. Shankar T, Petrov AA. Omalizumab and hypersensitivity reactions. Curr Opin Allergy Cl. 2013;13(1):19-24.
9. Liao J, Tang J, Jiang Y, Wang Y, Ding J, He Y. Effects of omalizumab on lung function in patients with moderate-to-severe allergic asthma: a systematic review and meta-analysis. Ther Adv Respir Dis. 2024;18:17534666231221771.
10. Lang D, Liu Z, Li D. Safety and Tolerability of Omalizumab in Children with Allergic (IgE-Mediated) Asthma: A Systematic Review and Meta-Analysis. Discov Med. 2023;35(176):233-41.
11. Wu Q, Zhang Y, Kong W, Wang X, Yuan L, Zheng R, et al. Which Is the Best Biologic for Nasal Polyps: Dupilumab, Omalizumab, or Mepolizumab? A Network Meta-Analysis. Int Arch Allergy Imm. 2022;183(3):279-88.
12. Yu C, Wang K, Cui X, Lu L, Dong J, Wang M, et al. Clinical Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Am J Rhinol Allergy. 2020;34(2):196-208.
13. Tsabouri S, Ntritsos G, Koskeridis F, Evangelou E, Olsson P, Kostikas K. Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis. Rhinology. 2021;59(6):501-10.
14. Casale TB, Bernstein IL, Busse WW, LaForce CF, Tinkelman DG, Stoltz RR, et al. Use of an anti-IgE humanized monoclonal antibody in ragweed-induced allergic rhinitis. J Allergy Clin Immun. 1997;100(1):110-21.
15. Plewako H, Arvidsson M, Petruson K, Oancea I, Holmberg K, Adelroth E, et al. The effect of omalizumab on nasal allergic inflammation. J Allergy Clin Immun. 2002;110(1):68-71.
16. Casale TB, Busse WW, Kline JN, Ballas ZK, Moss MH, Townley RG, et al. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immun. 2006;117(1):134-40.
17. Okubo K, Ogino S, Nagakura T, Ishikawa T. Omalizumab is effective and safe in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Allergol Int. 2006;55(4):379-86.
18. Nagakura T, Ogino S, Okubo K, Sato N, Takahashi M, Ishikawa T. Omalizumab is more effective than suplatast tosilate in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology. 2008;38(2):329-37.
19. Qi ZJ, Li HY, Wang T, Li F. Curative Efficacy of Omalizumab Combined with Budesonide in the Treatment of Allergic Rhinitis and Its Effects on the Peripheral Eosinophil Count and Serum IgE. Lab Immun Clin Med. 2021;28(12):2039-44.
20. Chang YJ, Zhang XL, Mao Y, Cheng YS. Efficacy of omalizumab combined with budesonide spray in the treatment of allergic rhinitis and its effect on the levels of neuropeptide in nasal seretions and serum immune inflammatory indexes. Journal of Clinical and Experimental Medicine. 2024;23(5):539-43.
21. Di Y, Yang YQ, Qi ZY, Li CJ, Fu ZQ. Application Value of Omalizumab on Patients with Allergic Rhinitis Based on Changes of Serum IgE Level and Olfactory Function. Progress in Modern Biomedicine. 2024;24(5):966-70.
22. Zhang Y, Xi L, Gao Y, Huang Y, Cao F, Xiong W, et al. Omalizumab is effective in the preseasonal treatment of seasonal allergic rhinitis. Clin Transl Allergy. 2022;12(1):e12094.
23. Cavaliere C, Begvarfaj E, Incorvaia C, Sposato B, Brunori M, Ciofalo A, et al. Long-term omalizumab efficacy in allergic rhinitis. Immunol Lett. 2020;227:81-7.
24. Gatta A, Della Valle L, Farinelli A, Cavallucci E, Paganelli R, Di Gioacchino M. Omalizumab in chronic spontaneous urticaria: steroid sparing effect. The Journal of Dermatological Treatment. 2018;29(sup3):6-9.
25. Mostafa BE, Fadel M, Mohammed MA, Hamdi TAH, Askoura AM. Omalizumab versus intranasal steroids in the post-operative management of patients with allergic fungal rhinosinusitis. European Archives of Oto-Rhino-Laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2020;277(1):121-8.
26. Liour SS, Tom A, Chan Y, Chang TW. Treating IgE-mediated diseases via targeting IgE-expressing B cells using an anti-CεmX antibody. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology. 2016;27(5):446-51.
27. Galvão VR, Castells MC. Hypersensitivity to biological agents-updated diagnosis, management, and treatment. The Journal of Allergy and Clinical Immunology. In Practice. 2015;3(2):175-86.
28. Kopp MV. Omalizumab: Anti-IgE therapy in allergy. Curr Allergy Asthm R. 2011;11(2):101-6.
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How to Cite
1.
Fu S, Lu J, Zhu Q, Yang B, Liu Z, Liu X, Tian J. Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Meta-analysis. Iran J Allergy Asthma Immunol. 2026;:1-6.
