‘Real-world’ effectiveness of omalizumab in adults with severe allergic asthma: a meta-analysis

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Abstract
: Severe asthma affects approximately 5-10% of the 350 million people with asthma worldwide and is characterized by persistent symptoms in spite of optimal treatment. Findings from the authors’ previous meta-analysis supported the use of omalizumab, a monoclonal antibody, as adjuvant treatment for severe allergic asthma. The publication of nine additional articles necessitates an update of the meta-analysis. : To evaluate the “real-world” effectiveness of omalizumab in the treatment of acute allergic asthma in adults by calculating pooled effects estimates from data in published articles. : Articles on the effectiveness of omalizumab in “real-world” settings were identified systematically. Effect sizes, including point estimates of the proportion of patients who met a given criteria, mean improvements relative to baseline, and change in the proportion of patients requiring oral corticosteroids compared to baseline were extracted. Meta-analysis of proportions was conducted to pool effect sizes based on proportions. Standardized mean differences in the form of Hedges’ g were calculated from means and standard deviations. Relative risk was calculated from changes in proportions. Variability within and between studies was evaluated. : Omalizumab increases the percentage of individuals rated “good” or “excellent” on the Global Evaluation of Treatment Effectiveness Scale and also improves respiratory function, quality-of-life and asthma control. Use of omalizumab also reduces medication usage, exacerbations, hospitalizations and adverse events. : “Real-world” evidence continues to support the use of omalizumab as an effective adjuvant treatment for severe allergic asthma.

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