Variability in total serum IgE over 1 year in severe asthmatics

Ondertitel:Variability in total serum IgE over 1year in severe asthmatics

Background: Immunoglobulin E (IgE) is the treatment target of omalizumab, a monoclonal antibody indicated in the treatment of severe allergic asthma. Long-term variability of serum total IgE (sIgE(tot)) in asthmatics remains poorly documented. Methods: In this prospective study, sIgE(tot) levels were measured over 1year at 7 time points in 41 severe asthmatics treated with high-dose of inhaled corticosteroids and long-acting (2) agonists. 33 patients were atopic based on at least one positive RAST to common aeroallergens. Patients were divided into three groups according to their baseline sIgE(tot) level: low (<76IU/mL; n=10), intermediate (76-700IU/mL; n=20) or high (>700IU/mL; n=11). Patients also completed the six-item Juniper Asthma Control Questionnaire (ACQ(6)). The sIgE(tot) variability and factors predictive for this variability were studied, as well as ACQ(6) outcomes. Results: The variation in sIgE(tot) level was mostly the consequence of between patient-variability, which represented 96%, 71% and 96% of the total variability in the low, intermediate and high sIgE(tot) subgroups, respectively. The residual within-patient variability was therefore limited. In 10/41 patients, sIgE(tot) levels increased or decreased, for at least one visit, beyond the predefined range of the subgroups to which they were assigned (<76IU/mL; 76-700IU/mL;>700IU/mL). There was a significant but weak correlation between sIgE(tot) and ACQ(6) score over all time points (r=0.15, p=0.02), but sIgE(tot) failed to associate with severe exacerbation. sIgE(tot) decreased by 3% with any additional year of age for the whole group (p=0.01) and increased by 5% per one unit of allergen exposure score in atopic patients (p=0.002). Conclusion: In severe asthmatics, limited within-patient variability of sIgE(tot) levels was observed over 1year as opposed to marked between-subject variability. sIgE(tot) decreases with age. Variation in sIgE(tot) weakly associates with asthma control but not with exacerbation.

Jaar van publicatie:2019

BOF-keylabel:ja

IOF-keylabel:ja

BOF-publication weight:0.1

Auteurs:International

Authors from:Private

Toegankelijkheid:Open