Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis
Chronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. We compared treatment effects and safety profiles of the medications in patients with CSU. We searched PubMed, MEDLINE, and Web of Science for randomized control trials (RCTs), from 1 January 2000 to 31 July 2021,...
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MDPI AG
2022-09-01
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| Online Access: | https://www.mdpi.com/2227-9059/10/9/2152 |
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| author | Wen-Kuang Lin Shwu-Jiuan Lin Woan-Ruoh Lee Chia-Chieh Lin Weei-Chin Lin Hua-Ching Chang Chi-Tsun Cheng Jason C. Hsu |
| author_facet | Wen-Kuang Lin Shwu-Jiuan Lin Woan-Ruoh Lee Chia-Chieh Lin Weei-Chin Lin Hua-Ching Chang Chi-Tsun Cheng Jason C. Hsu |
| author_sort | Wen-Kuang Lin |
| collection | DOAJ |
| description | Chronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. We compared treatment effects and safety profiles of the medications in patients with CSU. We searched PubMed, MEDLINE, and Web of Science for randomized control trials (RCTs), from 1 January 2000 to 31 July 2021, which evaluated omalizumab and immunosuppressants. Network meta-analyses (NMAs) were performed with a frequentist approach. Outcome assessments considered the efficacy (Dermatology Life Quality Index (DLQI) and weekly urticaria activity score (UAS7)) and tolerability profiles with evaluations of study quality, inconsistencies, and heterogeneity. We identified 14 studies which we included in our direct and indirect quantitative analyses. Omalizumab demonstrated better efficacy in DLQI and UAS7 outcomes compared to a placebo, and UAS7 assessments also demonstrated better outcomes compared to cyclosporine. Alongside this, omalizumab demonstrated relatively lower incidences of safety concerns compared to the other immunosuppressants. Cyclosporin was also associated with higher odds of adverse events than other treatment options. Our findings indicate that omalizumab resulted in greater improvements in terms of the DLQI and UAS7 with good tolerability in CSU patients compared to the other immunosuppressants. |
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| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T00:39:24Z |
| publishDate | 2022-09-01 |
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| series | Biomedicines |
| spelling | doaj.art-8b3231be9d3640e49a70c7b7afb6f28a2023-11-23T15:09:59ZengMDPI AGBiomedicines2227-90592022-09-01109215210.3390/biomedicines10092152Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-AnalysisWen-Kuang Lin0Shwu-Jiuan Lin1Woan-Ruoh Lee2Chia-Chieh Lin3Weei-Chin Lin4Hua-Ching Chang5Chi-Tsun Cheng6Jason C. Hsu7School of Pharmacy, Taipei Medical University, Taipei 110301, TaiwanSchool of Pharmacy, Taipei Medical University, Taipei 110301, TaiwanDepartment of Dermatology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 235041, TaiwanDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei 112201, TaiwanSection of Hematology/Oncology, Department of Medicine and Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USADepartment of Dermatology, Taipei Medical University Hospital, Taipei 110301, TaiwanResearch Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei 110301, TaiwanResearch Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei 110301, TaiwanChronic spontaneous urticaria (CSU) is the most common phenotype of chronic urticaria. We compared treatment effects and safety profiles of the medications in patients with CSU. We searched PubMed, MEDLINE, and Web of Science for randomized control trials (RCTs), from 1 January 2000 to 31 July 2021, which evaluated omalizumab and immunosuppressants. Network meta-analyses (NMAs) were performed with a frequentist approach. Outcome assessments considered the efficacy (Dermatology Life Quality Index (DLQI) and weekly urticaria activity score (UAS7)) and tolerability profiles with evaluations of study quality, inconsistencies, and heterogeneity. We identified 14 studies which we included in our direct and indirect quantitative analyses. Omalizumab demonstrated better efficacy in DLQI and UAS7 outcomes compared to a placebo, and UAS7 assessments also demonstrated better outcomes compared to cyclosporine. Alongside this, omalizumab demonstrated relatively lower incidences of safety concerns compared to the other immunosuppressants. Cyclosporin was also associated with higher odds of adverse events than other treatment options. Our findings indicate that omalizumab resulted in greater improvements in terms of the DLQI and UAS7 with good tolerability in CSU patients compared to the other immunosuppressants.https://www.mdpi.com/2227-9059/10/9/2152immunosuppressantbiological therapychronic spontaneous urticarianetwork meta-analysissystematic review |
| spellingShingle | Wen-Kuang Lin Shwu-Jiuan Lin Woan-Ruoh Lee Chia-Chieh Lin Weei-Chin Lin Hua-Ching Chang Chi-Tsun Cheng Jason C. Hsu Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis Biomedicines immunosuppressant biological therapy chronic spontaneous urticaria network meta-analysis systematic review |
| title | Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis |
| title_full | Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis |
| title_fullStr | Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis |
| title_full_unstemmed | Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis |
| title_short | Effectiveness and Safety of Immunosuppressants and Biological Therapy for Chronic Spontaneous Urticaria: A Network Meta-Analysis |
| title_sort | effectiveness and safety of immunosuppressants and biological therapy for chronic spontaneous urticaria a network meta analysis |
| topic | immunosuppressant biological therapy chronic spontaneous urticaria network meta-analysis systematic review |
| url | https://www.mdpi.com/2227-9059/10/9/2152 |
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