Anti-IgE: A treatment option in allergic rhinitis?

Abstract

Background: Allergic rhinitis (AR) is the most common IgE-mediated allergic disease. Multiple clinical trials have demonstrated promising results on the AR treatment with biologics, in particular with the use of omalizumab – an anti-IgE antibody. Omalizumab has also been established in the routine management of allergic asthma and chronic idiopathic urticaria. However, currently there is no approved license for the use of biologics in AR in Germany. Materials and methods: A systematic literature review has been completed including randomized controlled trials, meta-analyses, and reviews on the treatment of AR with omalizumab. Results: The systematic review demonstrates strong evidence supporting the use of omalizumab in the treatment of AR with regard to symptom control, safety profile, and management of comorbidities. Conclusion: Omalizumab is a good and safe option in the treatment of AR in terms of symptom control and the management of pre-existing comorbidities. Further clinical trials with other biologics in the management of AR are needed and are expected to follow soon.

ARIA Care Pathways 2019: Next-Generation Allergic Rhinitis Care and Allergen Immunotherapy in Malaysia

“…Any blockages or diseased tissue in the sinonasal region are removed during surgery, which can facilitate an easier intranasal use and delivery of topical spray. IgE monoclonal antibodies are a form of biologic drug that has been demonstrated to be useful in the treatment of AR [ 65 ]. These antibodies function by specifically targeting and neutralising IgE, a kind of antibody produced by the immune system in reaction to allergens.…”

Guideline on allergen immunotherapy in IgE-mediated allergic diseases

“…Concomitant administration of AIT with biologics (anti-IgE, anti-type 2 inflammation [ 376 , 377 ]) is thought to both reduce side effects and inhibit type 2 allergic inflammation. For the combination of anti-IgE (omalizumab) with AIT, there have been promising results with regard to the reduction of side effects.…”

“…For the combination of anti-IgE (omalizumab) with AIT, there have been promising results with regard to the reduction of side effects. However, larger, randomized, placebo-controlled trials are needed to transfer this strategy into routine clinical practice [ 377 , 378 ].…”

One hundred and ten years of Allergen Immunotherapy: A journey from empiric observation to evidence

“…The application of biologics to AIT is an emerging area of interest. At present, most experience has been with omalizumab which has been successfully used to reduce allergic symptoms during allergen up‐dosing (particularly effective for food AIT/OIT), and also to improve efficacy outcomes in aeroallergen AIT 127 and food AIT. Most recently, anti‐TSLP has been evaluated in combination with cat allergen AIT.…”