Related Experiment Videos
Omalizumab for pediatric allergic asthma: evidence-based insights on efficacy and safety from a meta-analysis of
Jinbiao Han1,2,3, Zhuan Zou1,2, Shanshan Wu1,2
1Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China.
Objectives:
This meta-analysis aimed to synthesize data from English-language randomized controlled trials (RCTs) to evaluate the efficacy and safety of omalizumab in patients aged 6-20 years with allergic asthma, with specific attention to age-stratified outcomes where feasible.
Methods:
Conducted in accordance with the PRISMA 2020 guidelines, this review followed a pre-registered protocol (PROSPERO: CRD420251132811). Eligible studies were English-language RCTs involving predominantly pediatric and adolescent patients with allergic asthma; one included trial enrolled participants up to 20 years of age, but only 15 participants (0.8% of the total sample) were aged 18-20 years, and all remaining participants were <18 years. Studies compared omalizumab with control treatment (placebo or standard therapy). Efficacy outcomes included asthma exacerbations, forced expiratory volume in 1 s (FEV1), and Childhood Asthma Control Test (C-ACT) scores. Safety outcomes encompassed treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and asthma-related hospitalizations. Data were pooled using random-effects models where appropriate, with heterogeneity assessed via I2 statistics.
Results:
Six RCTs involving 1,835 participants (omalizumab: 1,134; control: 701) aged 6-20 years were included. Omalizumab significantly reduced asthma exacerbations (relative risk RR = 0.66, 95% CI: 0.55-0.79; I2 = 51.6%), SAEs (RR = 0.56, 95% CI: 0.35-0.90; I2 = 43.1%), and hospitalizations (RR = 0.35, 95% CI: 0.22-0.56; I2 = 0.0%). No significant difference was found in TEAEs (RR = 0.96, 95% CI: 0.92-1.01; I2 = 1.5%). Evidence regarding lung function and asthma control was limited and could not be quantitatively pooled.
Conclusion:
Omalizumab is effective in reducing exacerbations, SAEs, and hospitalizations in pediatric and adolescent allergic asthma, with a favorable safety profile. Evidence regarding lung function and asthma control remains limited and should be interpreted cautiously. These findings support its use as an add-on therapy for moderate-to-severe disease inadequately controlled by standard treatments.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251132811, identifer CRD420251132811.
Related Concept Videos
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:24Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:29Respiratory Syncytial Virus Disease