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.