Comparison between chronic spontaneous urticaria and chronic induced urticaria on the efficacy of omalizumab treatment: A systematic review and meta‐analysis

Abstract

This meta-analysis aimed to assess the efficacy of omalizumab in the treatment of refractory-to-antihistamines chronic induced urticaria (CIndU) in comparison with that of refractory-to-antihistamines chronic spontaneous urticaria (CSU). We retrieved interventional studies and observational studies on omalizumab efficacy to CIndU patients and efficacy comparison between CSU and CIndU both refractory to H1-antihistamines in electronic databases (accessed till May 2022). The odd ratio (OR) and 95% confidence interval (CI) was calculated with a random-effect model in this meta-analysis. The majority of patients with different CIndU subtypes gained complete or partial response and good safety after omalizumab treatment. A total of five studies with 355 CSU patients and 103 CIndU patients were included for the meta-analysis. There was no significant difference in the efficacy of omalizumab in the treatment of CSU and CIndU (OR -0.83, 95% CI [0.84, 2.21], P > 0.05). Based on the validity of omalizumab in the treatment of various CIndU subtypes and nondifferential efficacy between CSU and CIndU, it is reasonable to list omalizumab as a third-line treatment of refractory CIndU.

Comparative efficacy and safety of the treatment by Omalizumab for chronic idiopathic urticaria in the general population: A systematic review and network meta‐analysis

“…To the best of our knowledge, this is the first NMA studying the efficacy and safety of varying dosage levels of omalizumab in a population of all ages with CIU. Unlike other meta‐analysis studies, this NMA analyzed the latest data from 12 eligible RCTs “head to head” 16,41 . The aggregate data network meta‐analysis ensured that we thoroughly examined these interventions in greater detail, enabling us to determine the magnitude of the efficacy among interventions and identify factors contributing to adverse events.…”

“…Unlike other meta‐analysis studies, this NMA analyzed the latest data from 12 eligible RCTs “head to head”. 16 , 41 The aggregate data network meta‐analysis ensured that we thoroughly examined these interventions in greater detail, enabling us to determine the magnitude of the efficacy among interventions and identify factors contributing to adverse events. The application of omalizumab aims to swiftly improve symptoms and reduce the need for additional medications, thereby effectively alleviating the manifestations of CIU and optimizing the overall outcomes.…”

Multinational Drug Survival Study of Omalizumab in Patients With Chronic Urticaria and Potential Predictors for Discontinuation

“…All currently recommended therapies, such as antihistamines and omalizumab, are not considered disease-modifying drugs . In randomized clinical trials, omalizumab, an anti–immunoglobulin E monoclonal antibody, was safe and effective in patients with antihistamine-refractory chronic spontaneous urticaria or chronic inducible urticaria . However, patients included in randomized clinical trials are not entirely representative of those seen in clinical practice.…”

“…1,3 In randomized clinical trials, omalizumab, an antiimmunoglobulin E monoclonal antibody, was safe and effective in patients with antihistamine-refractory chronic spontaneous urticaria or chronic inducible urticaria. [3][4][5][6][7][8] However, patients included in randomized clinical trials are not entirely representative of those seen in clinical practice. Currently, little is known about the long-term performance of omalizumab in daily practice regarding the lengths of treatment duration and reasons and potential predictors for treatment discontinuation.…”