Omalizumab Treatment Effective in Rhinoconjunctivitis

Omalizumab is a safe, effective treatment for both seasonal allergic rhinitis and associated ocular symptoms, according to research published in the Journal of Asthma and Allergy. The study shows significant quality-of-life improvements for patients with both rhinoconjunctivitis and nasal symptoms.

The researchers conducted an observational study of omalizumab therapy for seasonal allergic rhinitis in a cohort of Chinese patients. They analyzed the clinical efficacy and response predictors in real-world settings between June 2018 and March 2019. 

Included patients (n=60; 35 women) were between 6 years and 70 years of age (mean age, 35.47 years ± 17.02 years), diagnosed with seasonal allergic rhinitis, had a 2-year history of the condition, and positive results of a skin prick test or positive-specific immunoglobulin E test for pollens, with or without asthma (n=21 with asthma; n=36 with a family history of seasonal allergic rhinitis). The median omalizumab dose was 400 mg (range, 150 mg to 1800 mg) and the mean treatment duration was 2.9 months. 

The included participants took a mean 1.4 additional medications to treat seasonal allergic rhinitis, including allergen immunotherapy (32.8%), oral antihistamines (55%), antileukotrienes (28.3%), and intranasal glucocorticoids (20%). Among those with comorbid asthma, 61.9% were also using a corticosteroid/long-acting beta-agonist.

Following omalizumab treatment, both quality-of-life and seasonal allergic rhinitis symptoms improved significantly. Overall rhinoconjunctivitis quality of life questionnaire (RQLQ) score changed from approximately -2.55 to 0.47, with a substantial reduction of 2.08 points; scores within each domain of the RQLQ also demonstrated significant reductions. Nasal symptoms demonstrated relief, indicated via a reduction of total nasal symptom score (TNSS; 7.33 ± 2.50). 

Per an improvement threshold of 1 point or more in RQLQ overall score, 83.3% of patients responded to omalizumab therapy; 10 patients did not. Researchers noted no differences between responders and nonresponders in terms of baseline characteristics, but responders did have a higher overall RQLQ score at baseline and a higher TNSS (2.83 ± 0.90 and 10.28 ± 2.11, respectively). No further significant differences in RQLQ overall score or TNSS were noted between the 2 groups after treatment. 

Investigators performed a multiple linear regression analysis of baseline characteristics to identify which factors played a significant role in RQLQ change during treatment. Baseline overall RQLQ score was an independent predictor of RQLQ response to omalizumab; comparatively, factors such as age, sex, comorbid asthma, family history, pollen season treatment, total omalizumab dose, total serum immunoglobulin E, and allergen immunotherapy were not associated with RQLQ changes. 

“Omalizumab may improve nasal as well as ocular symptoms in patients with cedar pollen-induced seasonal allergy rhinitis,” according to the study. “Omalizumab is effective and safe in seasonal allergic rhinitis treatment in a real-world setting.” 

Reference

Ma T, Wang H, Wang X. Effectiveness and response predictors of omalizumab in treating patients with seasonal allergic rhinitis: A real-world study. J Asthma Allergy. 2021;14:59-66. doi:10.2147/JAA.S288952.