Omalizumab added to allergen immunotherapy increased the effect of therapy in patients with severe local allergic rhinitis

Abstract

Background Allergen immunotherapy (AIT) is effective in patient with local allergic rhinitis (LAR). However, AIT may not always achieve the optimal treatment effect. Objective To present short study with clinical cases of LAR combined therapy with sublingual immunotherapy (SLIT) and omalizumab in patients with house dust mite (HDM) allergy and compared it to therapy with omalizumab alone. Methods Patients with severe LAR and hypersensitivity to HDMs were included. SLIT for HDMs was launched in a perennial protocol using SQ-HDM SLIT tablets with omalizumab. The total rhinitis symptom score (TRSS), total medication score (TMS) and combined total score (CTS) were assessed after one year. Results After 12 months, significant improvements in all analyzed parameters in the patients on SLIT+ omalizumab therapy were observed: a reduction in the TRSS from 1.21 ± 0.33 to 0.6 ± 0.28 ( p < .05), a reduction in the TMS from 2.25 ± 1.05 to 0.88 ± 0.31 ( p < .05) and a reduction in the CTS from 3.46 ± 0.57 to 1.48 ± 0.51 ( p < .05). This improvement in TRSS, TMS also in CTS was significantly greater than in the rest of the group with SLIT alone or omalizumab alone. Conclusion Omalizumab may be a valuable treatment that increases the effectiveness of immunotherapy in patients with severe LAR.

Combination of omalizumab with allergen immunotherapy versus immunotherapy alone for allergic diseases: A meta‐analysis of randomized controlled trials

“…23,24,27,29,32,34 Epinephrine was given in emergency situations. 23,28,30,37 The rescue medication score was calculated by adding the total number of daily rescue medications during the treatment and then dividing this number by the total number of days. 23,24,27,29,32 We calculated the score based on the data supplied in the trials.…”

“…Eight studies [49][50][51][52][53][54][55][56] were parts of other included articles and contained no outcomes of interest. Finally, 11 articles (reporting the outcomes of nine trials) [26][27][28][29][30][31][32][34][35][36][37] were included in the review. The characteristics of the included trials are shown in Table 1.…”

“…Five trials were conducted in the United States, 26,29,31,32,34 two in Germany (four articles), 30,[35][36][37] and two in Poland. 27,28 A total of 901 participants were recruited, including 475 patients treated with the combination of omalizumab with AIT (omalizumab + AIT) and 426 controls (AIT alone, with or without placebo). The ages of the participants ranged from 4 to 55 years.…”

“…with a male-to-female ratio of 0.95:1. Furthermore, six trials [28][29][30][35][36][37] investigated AIT for AR, two for AA, 27,32 and three for FA. 26,31,34 The articles reported by Kamin et al 30 and Rolinck-Werninghaus et al 36 were follow-up studies after those by Kuehr et al, 35 all of which were from the same trial evaluating the safety 30 and efficacy 35,36 of the combination treatment.…”

“…16 The efficacy and safety of this combination therapy for allergic diseases have been evaluated in several randomized controlled trials (RCTs). [26][27][28][29][30][31][32][33][34][35][36][37] However, no consensus has been reached. Here, we performed a meta-analysis based on previous RCTs to reach a more representative and cohesive conclusion.…”