INTRODUCTION
Allergic rhinitis (AR) is a symptomatic nasal disorder induced by
inflammation in the nasal mucosa after allergen exposure. It´s a common
medical condition presenting with high prevalence in the general global
population with a substantial impact on the quality of life affecting
almost all daily activities of patients1. Symptoms of
AR include paroxysmal sneezing, watery rhinorrhea and nasal congestion
and itching, frequently accompanied by ocular symptoms including itchy
and watery eyes2. AR is a type I allergic disease
mediated by allergen-specific IgE.
Apart from specific allergen immunotherapy, currently available
therapeutic approaches, including mainly antihistamines and
corticosteroids, focus on symptom relief and although they do not
provide a permanent solution, they still remain first-line
treatment3. Omalizumab is a humanized monoclonal
antibody against immunoglobulin E (IgE) which blocks the binding of IgE
to high-affinity receptors (FceRI) on effector cells including mast
cells and basophils4 and has been used for the
treatment of patients with allergic rhinitis and has been evaluated in
several RCTs for allergic rhinitis5. However, the
evidence that stems from the individual currently available randomized
trials regarding the use of omalizumab in AR is not totally homogeneous.
In our previous work published in 2014, we found that the use of
omalizumab was associated with symptom relief, decrease in rescue
medication use, and improvement of quality of life in patients with
inadequately controlled allergic rhinosinusitis6.
Since then, additional RCTs have been published, providing new evidence
available to update our previous findings. Thus, certain points have
been raised that relate to the clinical aspects, the dosing schemes
administered, and the clinical scores of the patients with inadequately
controlled AR.
The aim of the present study was to update our previous work and
evaluate the efficacy and safety of omalizumab in RCTs in inadequately
controlled AR based on the currently available evidence evaluated
through a systematic review and meta-analysis.