[Efficacy and safety of omalizumab in patients with refractory allergic asthma: a meta-analysis].

To evaluate the efficacy and safety of omalizumab in patients with refractory allergic asthma using meta-analysis. We searched databases including PubMed, Web of Science, Embase and the website of ClinicalTrials. gov registry for randomized controlled trials (RCTs), using the search terms: ("anti-IgE" OR "anti-immunoglobulin E" OR "anti-IgE antibody" OR "omalizumab" OR "rhuMAb-E25" OR "Xolair") AND ("allergic asthma"). The time was up to September 19th 2020. Review Manager 5.4 software and Stata16 software were used to calculate pooled or , perform heterogeneity test, and assess publication bias. Fifteen RCTs with 6 316 patients in total (omalizumab, =3 469; placebo, =2 847) met our selection criteria. Comparing with placebo, omalizumab reduced the risk of asthma exacerbations during both stable-inhaled corticosteroid (ICS) phase (=0.69, 95%: 0.63-0.75, <0.001; =39.0%, =0.090) and ICS-reduction phase (=0.55, 95%: 0.46-0.66, <0.001; =41.0%, =0.180), reduced emergency visits (=0.53, 95%: 0.38-0.73, <0.001; =0, =0.420), made a significant reduction in dosage of ICS (1.35, 95%: 1.25-1.45, <0.001; =22.0%, =0.280) and even withdrew from ICS completely (=1.80, 95%: 1.41-2.31, <0.001; =57.0%, =0.070). Omalizumab significantly improved asthma-related quality of life (=1.81, 95%: 1.51-2.17). The use of rescue bronchodilators was significantly reduced in the omalizumab group (=0.78, 95%: 0.67-0.92) but there was no significant difference in the dosage of rescue bronchodilators (puff per day) (=-0.32, 95%: -0.77-0.13). Patients taking omalizumab did not increase the frequency of any adverse events (=1.01, 95%: 0.98-1.03) and serious adverse events (=0.89, 95%: 0.74-1.06). Omalizumab is an ideal adjunctive treatment for refractory allergic asthma with good efficacy and safety. Further randomized controlled trials are needed to determine the appropriate duration of treatment.