The effectiveness of anti-IgE therapy for allergic rhinitis in patients with severe atopic bronchial asthma and concomitant allergic rhinitis in real clinical practice

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


BACKGROUND: Omalizumab, by binding immunoglobulin (Ig) E in patients with atopic asthma, can improve clinical and functional parameters and patients’ quality of life.

AIM: To evaluate the efficacy of anti-IgE therapy in patients with allergic rhinitis treated with omalizumab for concomitant severe atopic asthma in real clinical practice

MATERIALS AND METHODS: This open, non-interventional, prospective, and non-randomized study in real clinical practice was conducted in the Sverdlovsk region in October 2021 based on a regional registry of adult patients with severe asthma with chronic nasal inflammatory diseases and receiving targeted therapy. Dynamics of nasal symptoms were assessed using the Sino-nasal-outcome test 22 (SNOT-22) questionnaire and visual analog scale (VAS) initially and after 4 and 12 months of omalizumab therapy. Peripheral blood eosinophil level was assessed before and after 4 months of omalizumab therapy.

RESULTS: The study included 26 patients. Assessment of nasal symptoms dynamics using the SNOT-22 questionnaire at baseline and after 4 months of omalizumab therapy revealed a decreased severity of symptoms (p <0.001) of 46.85±22.04 points at baseline (95% confidence interval [CI]: 37.94–55.75) and 30.65±14.81 points after 4 months (95% CI: 24.67–36.64). Additionally, improvement in SNOT-22 questionnaire score was revealed in 18 patients treated with omalizumab during 12 months, with 47.5 points before therapy (Q₁–Q₃: 35.7–59.3), 30.4 points after 4 months (Q₁–Q₃: 22.1–38.1), and 24.9 points after 12 months (Q₁–Q₃: 16.9–32.9) (p=0.001). Improvement in rhinitis symptoms control was observed according to the VAS scale, with 8.0 points before therapy (Q₁–Q₃: 6.2–9.0), 5.0 points after 4 months (Q₁–Q₃: 3.2–5.8), and 5.0 points after 12 months of treatment (Q₁–Q₃: 4.0–6.8). The eosinophil levels (n=16) decreased from 510.9±317.9 cells/µl (95% CI: 341.5–680.3) to 327.4±217.7 cells/µl (95% CI: 211.4–443.5) after 4 months of anti-IgE therapy (p <0.041).

CONCLUSIONS: Omalizumab in real clinical practice has demonstrated improvement of rhinitis symptoms and quality of life in patients with allergic rhinitis with concomitant severe atopic asthma. Additionally, a statistically significant decrease in peripheral blood eosinophils level was observed, which largely determines airway inflammation severity and clinical manifestations of allergic rhinitis and bronchial asthma.

Full Text

Restricted Access

About the authors

Darina V. Kiseleva

Ural State Medical University

Author for correspondence.
ORCID iD: 0000-0002-7847-5415
SPIN-code: 9446-7866
ResearcherId: AGI-2417-2022


Russian Federation, Ekaterinburg

Evgeny K. Beltyukov

Ural State Medical University

ORCID iD: 0000-0003-2485-2243
SPIN-code: 6987-1057
Scopus Author ID: 6504558662
ResearcherId: AAI-1608-2020

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ekaterinburg

Veronika V. Naumova

Ural State Medical University

ORCID iD: 0000-0002-3028-2657
SPIN-code: 8210-6478
ResearcherId: AAI-1588-2020

MD, Cand. Sci. (Med.)

Russian Federation, Ekaterinburg


  1. Astafieva NG, Baranov AA, Vishneva EA, et al. Allergic rhinitis. Russ Rhinology. 2020;28(4):246–256. (In Russ). doi: 10.17116/rosrino202028041246
  2. Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S103–S115. doi: 10.1016/j.jaci.2009.12.989
  3. Emelyanov AV, Ilina NI, Karneeva OV, et al. Unresolved issues of management of patients with severe allergic rhinitis and nasal polyposis. The possibilities of anti-IgE therapy. Russ Otorhinolaryngology. 2020;19(3):88–99. (In Russ). doi: 10.18692/1810-4800-2020-3-88-99
  4. Vlaykov A, Vicheva D, Dimov P, Stoyanov V. Assessment of quality of life in patients with allergic rhinitis. Russ Rhinology. 2016;24(1):38–42. (In Russ). doi: 10.17116/rosrino201624138-42
  5. Gaudin RA, Hoehle LP, Birkelbach MA, et al. Assoziation zwischen kontrolle der allergischen rhinitis und schlafqualität. HNO. 2017;65(12):987–992. doi: 10.1007/s00106-017-0398-9
  6. Hoehle LP, Speth MM, Phillips KM, et al. Association between symptoms of allergic rhinitis with decreased general health-related quality of life. Am J Rhinol Allergy. 2017;31(4):235–239. doi: 10.2500/ajra.2017.31.4444
  7. Mahdavinia M, Schleimer RP, Keshavarzian A. Sleep disruption in chronic rhinosinusitis. Expert Rev Anti Infect Ther. 2017;15(5): 457–465. doi: 10.1080/14787210.2017.1294063
  8. Speth MM, Hoehle L, Phillips KM, et al. Treatment history and association between allergic rhinitis symptoms and quality of life. J Med Sci. 2019;188(2):703–710. doi: 10.1007/s11845-018-1866-2
  9. Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Res J. 2013;43(2):343–373. doi: 10.1183/09031936.00202013
  10. Global Initiative for Asthma. Global strategy for asthma management and prevention, updated 2018. Available from: Accessed: 15.01.2022.
  11. Global Initiative for Asthma. Diagnosis and Management of Difficult-to-treat and Severe Asthma in adolescent and adult patients. V. 2.0, April 2019. Available from: Accessed: 15.01.2022.
  12. Allergic rhinitis. Clinical recommendations. The Russian Association of Allergology and Clinical Immunology; 2018. (In Russ). Available from: Accessed: 15.01.2022.
  13. Allergic rhinitis. Clinical recommendations. The Russian Association of Allergology and Clinical Immunology, National Medical Association of Otorhinolaryngologists, The Union of Pediatricians of Russia; 2020. (In Russ). Available from: Accessed: 15.01.2022.
  14. Mozzanica F, Preti A, Gera R, et al. Cross-cultural adaptation and validation of the SNOT-22 into Italian. Eur Arch Otorhinolaryngol. 2017;274 (2):887–895. doi: 10.1007/s00405-016-4313-x
  15. Masieri S, Cavaliere C, Begvarfaj E, et al. Effects of omalizumab therapy on allergic rhinitis: a pilot study. Eur Rev Med Pharmacol Sci. 2016;20(24):5249–5255.

Supplementary files

Supplementary Files
1. Fig. 1. Dynamics of the level of peripheral blood eosinophils during treatment with omalizumab.

Download (220KB)
2. Fig. 2. Dynamics indicators of VAS (visual analog scale) during anti-IgE therapy depending on the phenotype of chronic inflammatory disease of the nose (n=26).Note: Here and in Fig. 3: ХВЗН ― chronic inflammatory diseases of the nose; АР ― allergic rhinitis; ХРсПН ― chronic rhinosinusitis with nasal polyps; ХРбПН ― chronic rhinosinusitis without nasal polyps.

Download (258KB)
3. Fig. 3. Dynamics of scores SNOT-22 questionnaire on anti-IgE therapy depending on the phenotype of chronic inflammatory disease of the nose (n=26).

Download (257KB)
4. Fig. 4. Dynamics indicators of VAS (visual analog scale) during anti-IgE therapy after 4 and 12 months (n=18).

Download (219KB)
5. Fig. 5. Dynamics of scores SNOT-22 questionnaire on anti-IgE therapy after 4 and 12 months (n=18).

Download (224KB)
6. Fig. 6. Dynamics of symptoms of chronic inflammatory nasal diseases according to the SNOT-22 questionnaire for 12 months, n=18.

Download (543KB)

Copyright © Pharmarus Print Media, 2022

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies