title: Long-term efficacy and safety of omalizumab in patients with persistent uncontrolled allergic asthma: a systematic review and meta-analysis.
abstract: Currently, limited information is available to clinicians regarding the long-term efficacy of omalizumab treatment for allergic asthma. In this report, we aimed to (i) systematically review the evidence regarding the long-term efficacy of omalizumab in patients with persistent uncontrolled allergic asthma, and to (ii) discuss the cost-effectiveness evidence published for omalizumab in this patient population. A comprehensive search for randomized controlled trials (RCTs; ≥52 weeks) was performed, and six studies met our final inclusion criteria (n = 2,749). Omalizumab was associated with significant improvements in quality of life and the Global Evaluation of Treatment Effectiveness. Omalizumab also allowed patients to completely withdraw from inhaled corticosteroid therapy and did not increase the overall incidence of adverse events. However, there was insufficient evidence that omalizumab reduced the incidence of exacerbations, and the cost-effectiveness of omalizumab varied across studies. Our data indicated that omalizumab use for at least 52 weeks in patients with persistent uncontrolled allergic asthma was accompanied by an acceptable safety profile, but it lacked effect on the asthma exacerbations. Use of omalizumab was associated with a higher cost than conventional therapy, but these increases may be cost-effective if the medication is used in patients with severe allergic asthma.
authors: 1] Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China [2] Department of Respiratory and Critical Care Medicine, Affiliated Hospital, Institute of Respiratory Diseases, Guangdong Medicine College, Zhanjiang, China.
authors: Tianwen
authors: T
authors: Lai
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Shaobin
authors: S
authors: Wang
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Zhiwei
authors: Z
authors: Xu
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Chao
authors: C
authors: Zhang
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Yun
authors: Y
authors: Zhao
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Yue
authors: Y
authors: Hu
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Chao
authors: C
authors: Cao
authors: 1] Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China [2] Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China.
authors: Songmin
authors: S
authors: Ying
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Zhihua
authors: Z
authors: Chen
authors: Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China.
authors: Wen
authors: W
authors: Li
authors: Department of Respiratory and Critical Care Medicine, Affiliated Hospital, Institute of Respiratory Diseases, Guangdong Medicine College, Zhanjiang, China.
authors: Bin
authors: B
authors: Wu
authors: 1] Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, China [2] State Key Lab. for Respiratory Diseases, Guangzhou, China.
authors: Huahao
authors: H
authors: Shen
mesh_terms: D000367:Age Factors; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D006801:Humans; D000069444:Omalizumab / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents; D000069444:Omalizumab
references: Eur Ann Allergy Clin Immunol. 2011 Mar;43(2):45-53
references: 21608372
references: Ann Allergy Asthma Immunol. 2003 Aug;91(2):182-8
references: 12952113
references: J Am Diet Assoc. 2009 May;109(5):865-73
references: 19394473
references: Chest. 2004 Apr;125(4):1378-86
references: 15078749
references: Ann Allergy Asthma Immunol. 2003 Aug;91(2):154-9
references: 12952109
references: Health Technol Assess. 2013 Nov;17(52):1-342
references: 24267198
references: Pediatrics. 2004 Apr;113(4):e308-12
references: 15060258
references: Am J Respir Crit Care Med. 2001 Oct 15;164(8 Pt 2):S1-5
references: 11704610
references: Clin Exp Allergy. 2004 Apr;34(4):632-8
references: 15080818
references: J Allergy Clin Immunol. 2007 Nov;120(5):1146-52
references: 17904628
references: Ann Allergy Asthma Immunol. 2010 Dec;105(6):465-70
references: 21130385
references: Clin Exp Allergy. 2009 Jun;39(6):788-97
references: 19302249
references: Ann Intern Med. 2011 May 3;154(9):573-82
references: 21536936
references: J Asthma. 2012 Mar;49(2):144-52
references: 22277052
references: Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003559
references: 16625585
references: Sci Rep. 2014 Aug 18;4:6103
references: 25130484
references: Int Arch Allergy Immunol. 2013;160(1):102-10
references: 22948442
references: Chest. 2011 Jan;139(1):28-35
references: 20688929
references: Allergol Immunopathol (Madr). 2014 Jan-Feb;42(1):3-10
references: 23253691
references: Allergy. 2010 Sep;65(9):1141-8
references: 20148804
references: Ann Intern Med. 2009 Aug 18;151(4):W65-94
references: 19622512
references: Allergy. 2004 Jul;59(7):701-8
references: 15180756
references: Allergy. 2007 Feb;62(2):149-53
references: 17298423
references: J Allergy Clin Immunol. 2001 Aug;108(2):184-90
references: 11496232
references: Respir Med. 2008 Oct;102(10):1371-8
references: 18657960
references: JAMA. 2006 Jan 4;295(1):74-80
references: 16391219
references: Curr Med Res Opin. 2006 Sep;22(9):1765-76
references: 16968580
references: Ann Allergy Asthma Immunol. 2006 Feb;96(2):316-26
references: 16498854
references: Allergy. 2005 Mar;60(3):309-16
references: 15679715
references: BMJ. 1997 Sep 13;315(7109):629-34
references: 9310563
references: Curr Med Res Opin. 2011 Nov;27(11):2223-8
references: 21933100
references: J Allergy Clin Immunol. 2007 Jun;119(6):1454-61
references: 17481716
references: Allergy. 2008 Jun;63(6):670-84
references: 18445184
references: Allergy Asthma Proc. 2012 Sep-Oct;33(5):377-85
references: 23026179
references: Eur Respir J. 2002 Nov;20(5):1088-94
references: 12449159
references: Respir Med. 2007 Jul;101(7):1483-92
references: 17339107
references: Respirology. 2009 Nov;14(8):1156-65
references: 19909462
references: Clin Exp Allergy. 2009 Feb;39(2):271-9
references: 19016798
references: J Asthma. 2005 Dec;42(10):823-7
references: 16393718
references: Allergy Asthma Proc. 2009 Sep-Oct;30(5):534-9
references: 19467177
references: Curr Med Res Opin. 2010 Jun;26(6):1285-93
references: 20377320
references: Eur Respir J. 2001 Aug;18(2):254-61
references: 11529281
references: Pediatrics. 2001 Aug;108(2):E36
references: 11483846
references: Allergy. 2011 May;66(5):671-8
references: 21255035
references: J Med Econ. 2013;16(3):342-8
references: 23216016
references: Eur Respir J. 2002 Jul;20(1):73-8
references: 12166585
references: Allergy. 2005 Mar;60(3):302-8
references: 15679714
references: Respiration. 2012;83(6):520-8
references: 22236804
references: N Engl J Med. 2011 Mar 17;364(11):1005-15
references: 21410369
references: J Allergy Clin Immunol. 2009 Dec;124(6):1210-6
references: 19910033
references: Pulm Pharmacol Ther. 2002;15(5):417-24
references: 12406663
references: J Allergy Clin Immunol. 2004 Aug;114(2):265-9
references: 15316501
references: Respir Med. 2010 Nov;104(11):1608-17
references: 20801010
references: Curr Med Res Opin. 2006 Nov;22(11):2201-8
references: 17076981
references: Curr Med Res Opin. 2011 Jan;27(1):163-9
references: 21121874
references: J Asthma. 2012 Apr;49(3):288-93
references: 22356355
references: J Allergy Clin Immunol. 2010 Feb;125(2):383-9
references: 20159249
references: Allergy. 2004 Jul;59(7):709-17
references: 15180757
references: Pediatrics. 2002 Nov;110(5):e55
references: 12415061
references: Cochrane Database Syst Rev. 2014 Jan 13;(1):CD003559
references: 24414989
references: Int Arch Allergy Immunol. 2003 May;131(1):46-52
references: 12759489
references: J Allergy Clin Immunol. 2003 Feb;111(2):278-84
references: 12589345
references: Curr Med Res Opin. 2003;19(6):491-8
references: 14594521
references: BMJ. 2003 Sep 6;327(7414):557-60
references: 12958120