Evidence map›Paper›PMID 39673624›Full record

SynthesisArchives of dermatological research2024

Cost-effective omalizumab dosage for chronic urticaria: a systematic review and network meta-analysis.

Amin Tajerian, Ali Pourvali, Maryam Khoshkhui, Mehraneh Movahedi Aliabadi, Mahya Mobinikhaledi, Arezoo Faridzadeh

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of dermatological research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amin TajerianSchool of Medicine, Arak University of Medical Sciences, Arak, Iran.
Ali PourvaliDepartment of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Maryam KhoshkhuiDepartment of Allergy and Clinical Immunology, Mashhad University of Medical Sciences, Mashhad, Iran.
Mehraneh Movahedi AliabadiAllergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahya MobinikhalediSchool of Medicine, Arak University of Medical Sciences, Arak, Iran.
Arezoo FaridzadehDepartment of Allergy and Clinical Immunology, Mashhad University of Medical Sciences, Mashhad, Iran. faridzadeha2@mums.ac.ir.ORCID https://orcid.org/0000-0001-9094-6999

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic urticaria is a persistent skin condition characterized by recurrent wheals (hives) and/or angioedema lasting more than six weeks, significantly impacting quality of life and often requiring long-term management. Limited access to costly treatments like omalizumab poses challenges in low-income countries with high healthcare expenses and limited insurance coverage, prompting research into cost-effective dosages for effective management. This study aims to find the most cost-effective dosage for treating chronic urticaria in countries with healthcare affordability challenges. PubMed, MEDLINE, and Web of Science databases were searched for randomized controlled trials (RCTs) from January 1, 2010, to October 29, 2023. Studies assessing Omalizumab's efficacy in chronic spontaneous urticaria (CSU) patients unresponsive to antihistamines were included. Network meta-analyses (NMAs) were conducted using the "multinma" package in R, employing Bayesian random-effects models to synthesize data from multiple studies. Each outcome underwent separate analysis, with effect sizes illustrated via forest plots generated using Plotly in R. Individual studies' risk of bias was assessed using the Cochrane Risk of Bias Tool 2, and effect estimate certainty was rated via the GRADE approach. Consistency assumption was evaluated using the unrelated mean effects (UME) model, focusing on each data point's contribution to model fit. Present study showed that the 300 mg dose outperformed others and placebo in reducing urticaria activity score over 7 days (UAS7), weekly itch severity score (WWS), and weekly number of hives score (WIS). Response rates were notably higher with 300 mg, indicating its superiority in achieving treatment response. Given the significantly greater effect sizes of 150 mg and 300 mg over 75 mg and placebo, low doses aren't recommended for antihistamine-resistant cases. Initiating treatment with either a 300 mg dose for six months or starting with 150 mg and adjusting upwards as necessary is recommended, aligning with economic considerations until optimal dosages are established.

Indexed as

Chronic UrticariaCost-Benefit AnalysisOmalizumabAnti-Allergic AgentsHumansQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeAnti-Allergic AgentsOmalizumabChronic urticariaCost-effective treatmentHealthcare affordabilityNetwork meta-analysisOmalizumab

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.