In people with allergic rhinitis, omalizumab is an effective add-on therapy for controlling symptoms.

A prospective, single-center, open, uncontrolled observational study was conducted to evaluate the effectiveness of omalizumab as an add-on treatment during the pollen season in severe allergic rhinitis patients and to explore the duration and optimal regimen of the intervention.

Overall, 10 adults with severe aggravation of seasonal allergic rhinitis because of birch pollen were recruited. As per the Federal Clinical Guidelines, all the patients were given third-line of therapy and had incomplete or absence of control. The total nasal symptom score was >2.

All the recruited subjects were treated with omalizumab. Taking into consideration the weight of the patient and overall Immunoglobulin E (IgE) level, the regime and dose were prescribed as per the instructions. Assessment of requirement for rescue medication levels and daily symptom diaries was done. The key outcome was a reduction in Combined Medical and Symptom Score mean.

The add-on omalizumab therapy enhanced allergic rhinitis control for all subjects and also lowered rescue medication (ΔTNSS 1.8, and ΔCMSS 2.12, by the end of one week following the first omalizumab injection; and ΔTNSS 2.53, and ΔCMSS 5.22, by end of 4 weeks). For 3-7 days, omalizumab effect realization occurred. No side effects were observed during the trial.

Hence, the monoclonal antibody omalizumab is a valuable adjuvant treatment for symptomatic control of allergic rhinitis.  It should be given at least 1 week prior to the expected pollen season in people having severe exacerbation (as per previous seasons) who do not finish their allergen-specific immunotherapy on time, and continue therapy until the end of pollen season.