xRead - Olfactory Disorders (September 2023)

20426984, 2020, 7, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22576 by University Of Chicago Library, Wiley Online Library on [25/07/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

Biologics on CRSwNP-induced olfactory dysfunction

FIGURE1. Literature search strategy: PRISMA flowchart detailing literature search and review. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analysis.

Results Literature search

studies. 15,18,19 Subjects were randomized to receive: anti IgE therapy with omalizumab in 2 studies 14,17 ; anti–IL-5 therapy with mepolizumab in 2 studies 16,19 ; and anti–IL 4R α therapy with dupilumab in the last 3 RCTs. 15,18 The characteristics of the 7 included studies are presented in Table 1. Risk-of-bias assessment is presented in Figure 2. Four RCTs studied the efficacy of monoclonal antibodies in olfaction improvement with the use of the UPSIT olfac torytest 14,15,18 ; 1 with use of the visual analog scale score 19 ; and the last 2 with symptom scores. 16,17 In 2 RCTs the UP SIT score was combined with subjective ratings of smell score (scale 0-3). 15 A summary of the results is presented inTable 2. Omalizumab In the first study, with omalizumab, comparison across groups did not lead to a statistically significant net change in total UPSIT score (omalizumab, 3; placebo, 4; p < 0.31), although both treatment group (TRG) and control group (CRG) manifested an improvement (data not available). 14 On the other hand, in the second study, omalizumab led to a statistically significant decrease in loss of smell ( p = 0.04)

The systematic initial search in bibliographic databases re turned 2479 studies. Twenty-four additional records from trial registries were identified. After removing duplicates, 2462 publications were available for title-abstract screen ing. Finally, 43 articles that could provide data able to an swer the research question were identified. The full text of these studies was examined thoroughly, resulting in 7 RCTs that investigated the efficacy of monoclonal antibodies on the management of patients with CRSwNP. Only 3 of the aforementioned studies were eligible for quantitative syn thesis. The search methodology is demonstrated in Figure 1. Study characteristics Seven studies fulfilled the inclusion criteria. All were RCTs published between 2010 and 2019. A total of 957 patients were examined in the 7 RCTs, with 565 of them receiving monoclonal antibodies and 392 placebo. The total num ber of patients in these studies ranged from 14 14 to 448. 15 Three of the RCTs were performed at the same research center, 14,16,17 whereas the remaining 4 were multicentric

International Forum of Allergy & Rhinology, Vol. 10, No. 7, July 2020

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