title: Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials.
abstract: BACKGROUND
  Patients with moderate-to-severe allergic rhinitis who are inadequately controlled despite treatment according to current rhinitis management guidelines have a significant unmet medical need. Such patients have a negative impact on daily functioning and are at risk of developing serious comorbidities, such as asthma and chronic rhinosinusitis.
  
  
  OBJECTIVE
  To assess the efficacy and safety of omalizumab in poorly controlled allergic rhinitis under a meta-analysis framework.
  
  
  METHODS
  MEDLINE and the Cochrane Central Register of Controlled Trials were searched through September 2013. Studies on the efficacy of omalizumab in allergic rhinitis that assessed clinical outcomes were selected. Descriptive and quantitative information was extracted; mean differences and relative risk estimates were synthesized under a fixed or random effects model. Heterogeneity was assessed by using the Q statistic and the I(2) metric. Subgroup analyses were performed for the presence of specific immunotherapy treatment.
  
  
  RESULTS
  Of the 352 citations retrieved, 11 studies of 2870 patients were finally included. A statistically significant reduction in the daily nasal symptom severity score (standardized mean difference -0.67 [95% CI, -1.3 to -0.31]; P < .0001; I(2), 92%) and a statistically significant reduction in daily nasal rescue medication score (-0.22 [95% CI, -0.39 to -0.05; P = .01; I(2), 58%) were observed. There was not a statistically significant difference in the occurrence of any adverse event (relative risk 1.06 [95% CI, 0.94-1.19; I(2), 55%).
  
  
  CONCLUSIONS
  Omalizumab is statistically significantly associated with symptom relief, decreased rescue medication use, and improvement of quality of life in patients with inadequately controlled allergic rhinosinusitis.
authors.affiliation: Department of Paediatrics, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Tsabouri
authors.affiliation: Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Xanthippi
authors.initials: X
authors.lastname: Tseretopoulou
authors.affiliation: Third Department of Paediatrics, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Priftis
authors.affiliation: Evidence-based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. Electronic address: entzani@cc.uoi.gr.
authors.forename: Evangelia E
authors.initials: EE
authors.lastname: Ntzani
mesh_terms: D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D000069444:Omalizumab; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000706:statistics & numerical data; D065631:Rhinitis, Allergic / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab
keywords: Anti-IgE; Meta-analysis; Omalizumab; Rhinitis; Rhinosinusitis