Comparison 2. Subcutaneous omalizumab + steroid versus placebo + steroid (steroid reduction).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of participants with exacerbation	5	1726	Odds Ratio (M‐H, Fixed, 95% CI)	0.49 [0.39, 0.62]
1.1 Moderate to severe asthma	3	1388	Odds Ratio (M‐H, Fixed, 95% CI)	0.46 [0.36, 0.59]
1.2 Severe asthma	1	246	Odds Ratio (M‐H, Fixed, 95% CI)	0.59 [0.30, 1.16]
1.3 Severe (ICS and OCS users)	1	92	Odds Ratio (M‐H, Fixed, 95% CI)	0.88 [0.38, 2.01]
2 Exacerbations requiring hospitalisation	3	1405	Odds Ratio (M‐H, Fixed, 95% CI)	0.11 [0.03, 0.48]
2.1 Moderate asthma	3	1405	Odds Ratio (M‐H, Fixed, 95% CI)	0.11 [0.03, 0.48]
2.2 Severe asthma	0	0	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Number of participants achieving complete inhaled steroid withdrawal	4	1634	Odds Ratio (M‐H, Fixed, 95% CI)	2.50 [2.00, 3.13]
3.1 Moderate to severe	3	1388	Odds Ratio (M‐H, Fixed, 95% CI)	2.67 [2.10, 3.39]
3.2 Severe	1	246	Odds Ratio (M‐H, Fixed, 95% CI)	1.55 [0.80, 2.98]
4 Mean change in steroid consumption (BDP equivalent)	3	1188	Mean Difference (IV, Fixed, 95% CI)	‐118.76 [‐154.38, ‐83.14]
4.1 Moderate to severe asthma	2	942	Mean Difference (IV, Fixed, 95% CI)	‐114.08 [‐150.03, ‐78.13]
4.2 Severe asthma	1	246	Mean Difference (IV, Fixed, 95% CI)	‐372.0 [‐636.43, ‐107.57]
5 > 50% reduction in inhaled steroid usage	4	1634	Odds Ratio (M‐H, Fixed, 95% CI)	2.50 [2.02, 3.10]
5.1 Moderate to severe asthma	3	1388	Odds Ratio (M‐H, Fixed, 95% CI)	2.44 [1.93, 3.08]
5.2 Severe asthma	1	246	Odds Ratio (M‐H, Fixed, 95% CI)	2.84 [1.66, 4.86]
6 Mean steroid dose at end of reduction phase	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
6.1 Moderate to severe asthma	0		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Severe asthma	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Quality of life—change from baseline	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
7.1 Moderate to severe asthma	0		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Severe asthma	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Numbers of participants achieving clinically relevant improvement in quality of life (> 0.5)	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected
8.1 Severe asthma	1		Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Global evaluation rated good to excellent	2	842	Odds Ratio (M‐H, Fixed, 95% CI)	2.72 [2.04, 3.62]
9.1 Moderate to severe asthma	2	842	Odds Ratio (M‐H, Fixed, 95% CI)	2.72 [2.04, 3.62]
9.2 Severe asthma	0	0	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Rescue medication (puffs per day)	4	1373	Mean Difference (IV, Fixed, 95% CI)	‐0.74 [‐1.05, ‐0.43]
10.1 Moderate to severe asthma	2	1071	Mean Difference (IV, Fixed, 95% CI)	‐0.73 [‐1.06, ‐0.40]
10.2 Severe asthma (ICS)	1	220	Mean Difference (IV, Fixed, 95% CI)	‐0.7 [‐1.65, 0.25]
10.3 Severe asthma (ICS and OCS)	1	82	Mean Difference (IV, Fixed, 95% CI)	‐2.80 [‐7.40, 1.80]