A meta-analysis of randomized control trials (RCTs) depicted that the combination of Omalizumab (monoclonal anti-IgE antibody) and allergen immunotherapy (AIT) significantly enhanced the safety and effectiveness of AIT by elevating sustained unresponsiveness to allergens and target maintenance dose (TMD) while decreasing severe systemic adverse events. The researchers sought to determine if combining AIT with Omalizumab was more effective than using AIT monotherapy in addressing allergic diseases.

A search was conducted in databases such as Cochrane Library, Scopus, Embase, and PubMed/MEDLINE to find out RCTs that reported outcomes comparing Omalizumab with AIT (Omalizumab + AIT) in comparison with AIT alone. An analysis utilizing a random-effect model was employed to assess the endpoints, along with a 95% confidence interval. A meta-analysis was conducted using 11 eligible RCTs (901 participants).

The pooled analysis revealed that Omalizumab + AIT substantially raised the number of subjects attaining sustained unresponsiveness to allergens and TMD (with odds ratios [OR] of 6.77 and 2.43, respectively, and I2 values of 36% and 35%, respectively). Likewise, those undergoing the combined therapy experienced notably fewer occurrences of severe systemic adverse events (OR = 0.32; I2 = 0%) compared to AIT alone.

Concurrently, the enhancements in symptom severity score (mean difference [MD] = -0.26), the daily mean score for rescue medication (MD = -0.14), and the proportion of individuals using epinephrine in AIT (OR = 0.20) were all more pronounced than those observed in AIT alone. Hence, the combination therapy profoundly improved the safety and effectiveness of monotherapy, elevating TMD and sustained unresponsiveness to allergens while diminishing severe systemic AEs.