Summary

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• This summary is based on the review of 42 systematic review(s)/meta-analysis(es). ^[1-41]
• Chronic Rhinosinusitis with Nasal Polyps (CRSwNP): Omalizumab significantly improved nasal polyp score (NPS), nasal congestion score (NCS), and quality of life (sino-nasal outcome test (snot-22)), with long-term improvement maintenance. Dupilumab showed higher efficacy for NPS and quality of life than omalizumab and mepolizumab.
• Chronic Urticaria (CU): Omalizumab effectively reduced weekly itch and hive scores and improved Urticaria Activity Score (UAS7) and Dermatology Life Quality Index (DLQI), with 300 mg showing greater efficacy than 150 mg. Ligelizumab at 72 mg and 240 mg outperformed omalizumab 300 mg in reducing urticaria symptoms.
• Asthma: Omalizumab improved lung function (forced expiratory volume in 1 second (FEV₁)), reduced exacerbations, and decreased oral corticosteroid use with high certainty. Tezepelumab was more effective than omalizumab in reducing exacerbations and enhancing lung function.
• Food Allergies: Omalizumab increased tolerated doses of multiple foods and supported higher maintenance doses when used alone or with oral immunotherapy.
• Omalizumab did not significantly increase the incidence of adverse events (AEs) or serious adverse events (SAEs) compared to placebo across multiple conditions. No significant increase in drug-related SAEs was observed.
• Increased risk of rheumatic adverse events, specifically arthralgia or joint pain, was observed in CRSwNP patients. Some injection site reactions and systemic allergic reactions were reported but were not statistically significant.
• Similar safety profiles were noted among biologics; no significant difference in the incidence of AEs between ligelizumab and omalizumab. Dupilumab was associated with fewer nasopharyngitis cases compared to omalizumab, with a similar incidence of other AEs.
• Children and adolescents with atopic dermatitis showed limited efficacy data for omalizumab, with improvements in SCORing Atopic Dermatitis (SCORAD) scores but lower effectiveness than dupilumab; no specific safety concerns were noted for this group. For severe asthma patients, omalizumab consistently improved lung function and reduced exacerbations without significant increases in serious adverse events. In food allergy patients, omalizumab was effective in increasing tolerated doses, especially in combination with oral immunotherapy, with mild to moderate adverse events. Elderly patients with chronic urticaria experienced symptom control and quality of life improvements, though polypharmacy and comorbidities should be carefully managed.