Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis
Background: The stability, efficacy, and safety of omalizumab at different doses and regimens for chronic spontaneous urticaria (CSU) are yet to be studied. Objective: A systematic review (SR) with meta-analysis (MA) and trial sequential analysis (TSA) was performed to assess the efficacy and safety...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | World Allergy Organization Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455124000292 |
| _version_ | 1797213369101451264 |
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| author | Haiyan Qin, MD Xianjun Xiao, MD, PhD Di Qin, MD Peiwen Xue, MD Huilin Liu, MD Ying Li, MD, PhD Yunzhou Shi, MD, PhD |
| author_facet | Haiyan Qin, MD Xianjun Xiao, MD, PhD Di Qin, MD Peiwen Xue, MD Huilin Liu, MD Ying Li, MD, PhD Yunzhou Shi, MD, PhD |
| author_sort | Haiyan Qin, MD |
| collection | DOAJ |
| description | Background: The stability, efficacy, and safety of omalizumab at different doses and regimens for chronic spontaneous urticaria (CSU) are yet to be studied. Objective: A systematic review (SR) with meta-analysis (MA) and trial sequential analysis (TSA) was performed to assess the efficacy and safety of omalizumab in CSU. Methods: Randomised controlled trials (RCTs) of administering omalizumab versus placebo for CSU were searched. Random-effects MAs were performed using planned subgroup analyses. TSA was performed to control for the risk of random errors and assess the stability of our MA results. Publication bias was visually assessed using a contour-enhanced funnel plot and the trim-and-fill method. The quality of RCTs was assessed using the Cochrane Risk of Bias Tool 2. Results: Twelve studies met the inclusion criteria. Omalizumab had remarkable effects on the patient percentage of the weekly urticaria activity score is zero (UAS = 0) [RR 4.64, 95% CI (3.38, 6.37)], percentage of no angioedema-burdened days [MD 3.15, 95% CI (0.10, 6.19], patient percentage of UAS ≤6 [RR 3.05, 95% CI (2.46, 3.78)], and patient percentage of the weekly itch severity score minimally important difference (ISS7 MID) [RR 1.50, 95% CI (1.36, 1.66)]. Omalizumab was well tolerated across studies [RR 0.98, 95% CI (0.90, 1.08)]. TSA confirmed the above results, except for “the percentage of no angioedema-burdened day”. Conclusion: Among the different doses and courses assessed, omalizumab (300 mg, 12 weeks) can be recommended as an effective treatment for patients with CSU. However, whether omalizumab improves angioedema requires further investigation. The clinical management of angioedema accompanying CSU requires further attention. |
| first_indexed | 2024-04-24T10:57:11Z |
| format | Article |
| id | doaj.art-2728ab7efdda48f287e10eb5aef32a04 |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-04-24T10:57:11Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-2728ab7efdda48f287e10eb5aef32a042024-04-12T04:45:04ZengElsevierWorld Allergy Organization Journal1939-45512024-04-01174100898Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysisHaiyan Qin, MD0Xianjun Xiao, MD, PhD1Di Qin, MD2Peiwen Xue, MD3Huilin Liu, MD4Ying Li, MD, PhD5Yunzhou Shi, MD, PhD6Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Corresponding author. No. 37 Shierqiao Road, Jinniu District, Chengdu, 610075, Sichuan, China.Background: The stability, efficacy, and safety of omalizumab at different doses and regimens for chronic spontaneous urticaria (CSU) are yet to be studied. Objective: A systematic review (SR) with meta-analysis (MA) and trial sequential analysis (TSA) was performed to assess the efficacy and safety of omalizumab in CSU. Methods: Randomised controlled trials (RCTs) of administering omalizumab versus placebo for CSU were searched. Random-effects MAs were performed using planned subgroup analyses. TSA was performed to control for the risk of random errors and assess the stability of our MA results. Publication bias was visually assessed using a contour-enhanced funnel plot and the trim-and-fill method. The quality of RCTs was assessed using the Cochrane Risk of Bias Tool 2. Results: Twelve studies met the inclusion criteria. Omalizumab had remarkable effects on the patient percentage of the weekly urticaria activity score is zero (UAS = 0) [RR 4.64, 95% CI (3.38, 6.37)], percentage of no angioedema-burdened days [MD 3.15, 95% CI (0.10, 6.19], patient percentage of UAS ≤6 [RR 3.05, 95% CI (2.46, 3.78)], and patient percentage of the weekly itch severity score minimally important difference (ISS7 MID) [RR 1.50, 95% CI (1.36, 1.66)]. Omalizumab was well tolerated across studies [RR 0.98, 95% CI (0.90, 1.08)]. TSA confirmed the above results, except for “the percentage of no angioedema-burdened day”. Conclusion: Among the different doses and courses assessed, omalizumab (300 mg, 12 weeks) can be recommended as an effective treatment for patients with CSU. However, whether omalizumab improves angioedema requires further investigation. The clinical management of angioedema accompanying CSU requires further attention.http://www.sciencedirect.com/science/article/pii/S1939455124000292Chronic spontaneous urticariaOmalizumabTrial sequential analysisEfficacyStability |
| spellingShingle | Haiyan Qin, MD Xianjun Xiao, MD, PhD Di Qin, MD Peiwen Xue, MD Huilin Liu, MD Ying Li, MD, PhD Yunzhou Shi, MD, PhD Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis World Allergy Organization Journal Chronic spontaneous urticaria Omalizumab Trial sequential analysis Efficacy Stability |
| title | Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis |
| title_full | Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis |
| title_fullStr | Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis |
| title_full_unstemmed | Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis |
| title_short | Different doses and courses of omalizumab for patients with chronic spontaneous urticaria: A systematic review with meta-analysis and trial sequential analysis |
| title_sort | different doses and courses of omalizumab for patients with chronic spontaneous urticaria a systematic review with meta analysis and trial sequential analysis |
| topic | Chronic spontaneous urticaria Omalizumab Trial sequential analysis Efficacy Stability |
| url | http://www.sciencedirect.com/science/article/pii/S1939455124000292 |
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