Real-World Data Evaluation Of Total IgE, Specific IgE And Omalizumab Therapy In A Cohort Of Allergic Asthma Patients Treated In A Community-Based Practice

2020 ◽  
Author(s):  
Fortune O Alabi
Keyword(s):  
Allergic Asthma ◽  
Specific Ige ◽  
Forced Expiratory Volume ◽  
Act Scores ◽  
Asthma Control Test ◽  
Real World Data ◽  
Total Ige ◽  
Prick Test ◽  
Negative Results ◽  
Asthma Patients

Objective: In this study, we: (1) evaluated the correlation between total IgE and the presence of specific IgE; (2) compared the characteristics of patients with positive specific IgE to those with negative specific IgE; and, (3) analyzed the allergic testing results of patients on omalizumab and reported the effect of omalizumab on forced expiratory volume (FEV1) and asthma control test (ACT) results. Methods: Data from patients diagnosed with allergic asthma and seen at Florida Lung, Asthma & Sleep Specialists (FLASS) between January 2016 and June 2019 were analyzed. Parameters evaluated were total IgE, and levels of specific IgE to antigens in the ImmunoCAP test and skin prick test (SPT). Additional parameters for patients on omalizumab therapy for at least 6 months were FEV1, % predicted FEV1 and ACT results. Results: A total of 475 patients (114 males, 361 females) met the inclusion criteria. The mean age was 53 years (range: 17 to 89 years). Of these, 36 patients were not included in the analysis due to incomplete data. Mean total IgE was higher in patients with positive ImmunoCAP results compared to those with negative results (396 KU/L vs. 81.3 KU/L). There was a significant positive correlation between total IgE and levels of positive specific IgE in the ImmunoCAP test (p<0.0001, r=0.36, n=213 patients). The correlation between total IgE and levels of positive allergens in SPT was not significant (p=0.15, n=44 patients) Two positive reactions to allergens were seen in 22% of ImmunoCAP tests and 13% of SPT tests. There was no statistically significant improvement in FEV1 (p=0.097, CI -0.17 to 0.02) and % predicted FEV1 (p=0.109, CI -6.63 to 0.70) in patients who used omalizumab for at least 6 months. There was a statistically significant improvement in ACT scores (p=0.031, CI -4.21 to -0.21) in patients who used omalizumab for at least 6 months. Conclusion: Allergic asthma could be seen in patients who had an absence of specific IgE in ImmunoCAP and a negative reaction to SPT. The benefit of omalizumab therapy is not limited to allergic asthma patients with positive specific IgE.

scholarly journals Clinical Evaluation for Sublingual Immunotherapy With Dermatophagoides farinae in Polysensitized Allergic Asthma Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Ai-zhi Zhang ◽  
Mei-e Liang ◽  
Xiao-xue Chen ◽  
Yan-fen Wang ◽  
Ke Ma ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Sublingual Immunotherapy ◽  
Initial Response ◽  
Similar Efficacy ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Dermatophagoides Farinae ◽  
Asthma Control Test ◽  
Asthma Patients ◽  
Long Acting

Background: Many studies have demonstrated the efficacy of single-allergen sublingual immunotherapy (SLIT) in polysensitized patients with allergic rhinitis (AR), but less is reported in polysensitized patients with allergic asthma (AS).Method: Data of 133 adult patients with house dust mite (HDM)-induced AS who had been treated for 3 years were collected. These patients were divided into the control group (treated with low to moderate dose of inhaled glucocorticoids and long-acting β2 agonists, n = 37) and the SLIT group (further treated with Dermatophagoides farinae drops, n = 96). The SLIT group contained three subgroups: the single-allergen group (only sensitized to HDM, n = 35), the 1- to 2-allergen group (HDM combined with one to two other allergens, n = 32), and the 3-or-more-allergen group (HDM combined with three or more other allergens, n = 29). The total asthma symptom score (TASS), total asthma medicine score (TAMS), and asthma control test (ACT) were assessed before treatment and at yearly visits. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) was assessed before treatment and at the end of SLIT.Results: TASS and ACT scores in the control group were significantly higher than that in the single-allergen group and the 1- to 2-allergen group after 1, 2, and 3 years of SLIT and significantly higher than that in the 3-or-more-allergen group after 3-year SLIT (all p &lt; 0.05). TAMS of the control group was significantly higher than that of the other three groups after 0.5, 1, 2, and 3 years of SLIT (all p &lt; 0.05). FEV1/FVC in the control group was significantly higher than baseline after 3 years of immunotherapy (p &lt; 0.05).Conclusion: Patients sensitized to HDM with/without other allergens showed similar efficacy after 3 years of SLIT. However, the initial response of patients with three or more allergens was slower during immunotherapy process.

scholarly journals IL-8, IL-10, TGF-β, and GCSF Levels Were Increased in Severe Persistent Allergic Asthma Patients with the Anti-IgE Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Arzu D. Yalcin ◽  
Atil Bisgin ◽  
Reginald M. Gorczynski
Keyword(s):  
Healthy Volunteers ◽  
Allergic Asthma ◽  
Persistent Asthma ◽  
High Sensitivity ◽  
Specific Ige ◽  
Th2 Cells ◽  
Newly Diagnosed ◽  
Asthma Control Test ◽  
Cytokine Levels ◽  
Asthma Patients

Background. Allergic asthma is showed an increase in Th2-cytokine and IgE levels and an accumulation activation of Th2 cells, eosinophils and mast cells. However, recent studies focused on cell-based mechanisms for the pathogenesis of allergic asthma.Objectives. In this study, we compare the anti-IgE treatment modality in the dynamics of immune system cytokine levels in severe persistent asthma (SPA) patients who had no other any allergic disease, newly diagnosed allergic asthma patients and healthy volunteers.Study Design. The study population consisted of 14 SPA patients, 14 newly diagnosed allergic asthma patients and 14 healthy volunteers included as controls. Cytokine levels were measured. Total and specific IgE levels of anti-IgE monoclonal antibody treated patients, serum high-sensitivity C-reactive protein (hsCRP) levels, FEV1/FVC rates and asthma control test (ACT) were measured for the clinical follow-up.Results. We observed that SPA patients presented increasing levels of IL-8, IL-10, TGF-βand GCSF during the anti-IgE treatment in period of sampling times at 4 months and 18 months. However this increase was not correlated neither with serum hsCRP levels nor FEV1/FVC rates.Conclusions. Our study gives a different perspective for the SPA and anti-IgE immunotherapy efficacy at the cell cytokine-linked step.

Identifying the Clinical Pattern of Eosinophilic and Non-Eosinophilic Asthma subtype in adult patients with Bronchial Asthma

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maged Mohammed Refaat ◽  
Dina Sayed Sheha ◽  
Riham Hazem Raaft ◽  
Maged Mohamed Refaat ◽  
Heba Eid Farhat Abo Alia ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Skin Prick Testing ◽  
Nasal Endoscopy ◽  
Asthma Control Test ◽  
Eosinophilic Asthma ◽  
Total Ige ◽  
Common Chronic Disease ◽  
Sputum Eosinophilia ◽  
Asthma Patients ◽  
The Mean

Abstract Background Context:- Asthma is a heterogenous disease with various phenotypes, it is the most common chronic disease characterized by airway limitation due to bronchospasm and airway inflammation associated with excessive mucus secretion from agitated mucus gland that occur due to air way hyper responiveness. Purpose of the study Comparison between eosinophilic and non-eosinophilic asthma patients. Patients and Methods 100 bronchial asthma patients of age ≥ 18 years old divided into2 groups according to blood eosinophilia. All patients were subjected to: history. Total Asthma Control Test. Spirometry. Sputum eosinophil count. IgE levels 6-Skin prick testing (SPT). Nasal endoscopy. Results the mean age of all patients was (35.4 ± 12.8) years, majority (61%) of patients were males,; the mean ACT score was (18.7 ± 2); 39% of cases have obstructive pattern by spirometry, 39% of cases had abnormal nasal endoscopy, SPT had significant relation with asthma, there is significant correlation between total IGE,sputum eosinophilia with eosinophilic asthma. Conclusion Blood eosinophils had the highest accuracy in the identification of sputum eosinophilia in asthma. Total IgE values and sutum eosinophilia were markedly increased in patients with eosinophilic asthma more than patients with non-eosinophilic asthma.

scholarly journals Meta-analysis of vitamin D and lung function in patients with asthma

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jian Liu ◽  
Yong-Quan Dong ◽  
Jie Yin ◽  
Jian Yao ◽  
Jie Shen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Lung Function ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Forced Expiratory Volume ◽  
Asthma Control Test ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Asthma Patients ◽  
Sufficient Vitamin

Abstract Background There is growing literature suggesting a link between vitamin D and asthma lung function, but the results from systematic reviews are conflicting. We conducted this meta-analysis to investigate the relation between serum vitamin D and lung function in asthma patients. Methods Major databases, including OVID, MEDLINE, Web of Science and PUBMED, were searched until 10th October 2018. All published observational studies related to vitamin D and asthma were extracted. All meta-analyses were performed using Review Manager 5.3.5. Results This quantitative synthesis found that asthma patients with low vitamin D levels had lower forced expiratory volume In 1 s (FEV1) (mean difference (MD) = − 0.1, 95% CI = − 0.11 to − 0.08,p < 0.01;I2 = 49%, p = 0.12) and FEV1% (MD = − 10.02, 95% CI = − 11 to − 9.04, p < 0.01; I2 = 0%, p = 0.82) than those with sufficient vitamin D levels. A positive relation was found between vitamin D and FEV1 (r = 0.12, 95% CI = 0.04 to 0.2, p = 0.003; I2 = 59%,p = 0.01), FEV1% (r = 0.19, 95% CI = 0.13 to 0.26, p < 0.001; I2 = 42%, p = 0.11), forced vital capacity (FVC) (r = 0.17, 95% CI = 0.00 to 0.34, p = 0.05; I2 = 60%, p = 0.04), FEV1/FVC (r = 0.4, 95% CI = 0.3 to 0.51, p < 0.001; I2 = 48%, p = 0.07), and the asthma control test (ACT) (r = 0.33, 95% CI = 0.2 to 0.47, p < 0.001; I2 = 0%, p = 0.7). Subgroup analysis indicated that the positive correlation between vitamin D and lung function remained significant in both children and adults. Conclusions Our meta-analysis suggested that serum vitamin D levels may be positively correlated with lung function in asthma patients. Future comprehensive studies are required to confirm these relations and to elucidate potential mechanisms.

scholarly journals Prick Test Results and Total IgE Levels of Asthma Patients in A University Hospital

2019 ◽  
Vol 24 (3) ◽  
pp. 276-279
Author(s):  
Barış Çil ◽  
Mehmet Kabak ◽  
İclal Hocanlı ◽  
Ayşe Füsun Topçu ◽  
Mahşuk Taylan
Keyword(s):  
University Hospital ◽  
Test Results ◽  
Total Ige ◽  
Prick Test ◽  
Asthma Patients

scholarly journals Switching from omalizumab to mepolizumab: real-life experience from Southern Italy

2020 ◽  
Vol 14 ◽  
pp. 175346662092923 ◽  
Author(s):  
Giovanna Elisiana Carpagnano ◽  
Corrado Pelaia ◽  
Maria D’Amato ◽  
Nunzio Crimi ◽  
Nicola Scichilone ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Severe Asthma ◽  
Southern Italy ◽  
Life Experience ◽  
Real Life ◽  
Forced Expiratory Volume ◽  
Asthma Control Test ◽  
Eosinophilic Asthma ◽  
Life Study ◽  
First Choice

Background: Current availability of several biologic treatments for severe asthma makes it possible to choose the most appropriate for each patient. Sometimes a good percentage of patients with severe asthma may be eligible for biologics that target either the allergic phenotype or the eosinophilic one, but not all respond to that selected as first choice. The aim of our real-life study was to assess whether, for patients with severe eosinophilic allergic asthma, not previously controlled by the anti-IgE omalizumab, the shift to another biologic targeting interleukin-5, such as mepolizumab, may represent a good therapeutic choice. Methods: A total of 41 consecutive patients with severe, persistent allergic, eosinophilic asthma, uncontrolled despite treatment with omalizumab, were enrolled in seven certified Clinical Respiratory Units of Southern Italy (Catania, Catanzaro, Foggia, Bari, Palermo, and two University Respiratory Units of Naples) and shifted to mepolizumab without a wash-out period. Data at baseline, after at least 12 months of therapy with omalizumab, and after at least 12 months of treatment with mepolizumab were collected. Results: After at least 12 months of therapy with mepolizumab, patients experienced a significant decrease in the number of exacerbations/year (5.8 ± 1.8 versus 0.7 ± 0.9, p < 0.0001), an increment of asthma control test score (12 ± 2.7 versus 21.9 ± 2.7, p < 0.0001), an increase in pre-bronchodilator forced expiratory volume in 1 s (1.56 ± 0.45 l versus 1.86 ± 0.52 l, p < 0.0001), and a reduction of blood eosinophils (584 ± 196 cells/µl versus 82 ± 56 cells/µl, p < 0.0001). The percentage of patients who were dependent on corticosteroids significantly decreased from 46% at baseline to 5% during treatment with mepolizumab. Conclusion: Results of our real-life multicentric experience confirms that the shift to mepolizumab could be a good therapeutic strategy in severe eosinophilic allergic asthma not previously controlled by omalizumab. The reviews of this paper are available via the supplemental material section.

Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

2020 ◽  
Vol 35 (1) ◽  
pp. 98-106
Author(s):  
Sasiwimon Traiyan ◽  
Wiparat Manuyakorn ◽  
Watcharoot Kanchongkittiphon ◽  
Cherapat Sasisakulporn ◽  
Wanlapa Jotikasthira ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Provocation Test ◽  
Specific Ige ◽  
Prick Test ◽  
The Past ◽  
Negative Results ◽  
Dust Mite ◽  
The Mean ◽  
Positive Results

Background Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.

scholarly journals Fluctuation-based clustering reveals phenotypes of patients with different asthma severity

2020 ◽  
Vol 6 (2) ◽  
pp. 00007-2019
Author(s):  
Anja Jochmann ◽  
Luca Artusio ◽  
Hoda Sharifian ◽  
Angela Jamalzadeh ◽  
Louise J. Fleming ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Asthma Severity ◽  
Forced Expiratory Volume ◽  
High Dose ◽  
Act Scores ◽  
Asthma Control Test ◽  
Daily Fluctuation ◽  
Difficult Asthma ◽  
Act Score ◽  
Cluster 2

Serial peak expiratory flow (PEF) measurements can identify phenotypes in severe adult asthma, enabling more targeted treatment. The feasibility of this approach in children has not been investigated.Overall, 105 children (67% male, median age 12.4 years) with a range of asthma severities were recruited and followed up over a median of 92 days. PEF was measured twice daily. Fluctuation-based clustering (FBC) was used to identify clusters based on PEF fluctuations. The patients’ clinical characteristics were compared between clusters.Three PEF clusters were identified in 44 children with sufficient measurements. Cluster 1 (27% of patients: n=12) had impaired spirometry (mean forced expiratory volume in 1 s (FEV1) 71% predicted), significantly higher exhaled nitric oxide (≥35 ppb) and uncontrolled asthma (asthma control test (ACT) score <20 of 25).Cluster 2 (45%: n=20) had normal spirometry, the highest proportion of difficult asthma and significantly more patients on a high dose of inhaled corticosteroids (≥800 µg budesonide).Cluster 3 (27%: n=12) had mean FEV1 92% predicted, the highest proportion of patients with no bronchodilator reversibility, a low ICS dose (≤400 µg budesonide), and controlled asthma (ACT scores ≥20 of 25).Three clinically relevant paediatric asthma clusters were identified using FBC analysis on PEF measurements, which could improve telemonitoring diagnostics. The method remains robust even when 80% of measurements were removed. Further research will determine clinical applicability.

Anti-IgE Significantly Changes Circulating Interleukin-25, Vitamin-D and Interleukin-33 Levels in Patients with Allergic Asthma

2019 ◽  
Vol 25 (35) ◽  
pp. 3784-3795 ◽  
Author(s):  
Arzu D. Yalcin ◽  
Rusen Uzun
Keyword(s):  
Significant Relationship ◽  
Eosinophil Cationic Protein ◽  
Length Of Hospital Stay ◽  
Specific Ige ◽  
The Other ◽  
Act Scores ◽  
Asthma Control Test ◽  
Cationic Protein ◽  
Interleukin 33 ◽  
Asthmatic Patients

Background: Multi-center, randomized-controlled trials and observational studies have demonstrated that, in severe asthmatic patients receiving omalizumab treatment, the frequency of exacerbations, the number of urgent adverse events, and the need for oral steroids tend to decrease. Material and Method: This study included a total of 32 patients. The patients were divided into two groups as Group IA (pre-omalizumab) and Group IB (post-omalizumab). Serum IL-25 and IL-33 levels were measured and the number of emergency admissions, length of hospitalization (day), Asthma Control Test (ACT) scores, eosinophil cationic protein (ECP), and fractional exhaled nitric oxide (FeNO) value were analyzed. Results: ACT and FeNO values increased after omalizumab treatment, while IL-33, IL-25 levels decreased after the completion of omalizumab treatment. Furthermore, there was a weak, positive, and significant relationship between the changes in the ECP levels and IL-33 levels (r=0.38, p=0.03). Conclusion: To the best of our knowledge, this is the first study to compare circulating IL-25 and IL-33 levels with specific IgE synthesis in the literature. Multivariate correlation analysis showed that the changes in serum IL-33 levels were significantly correlated with the changes in the mite sIgE levels and length of hospital stay (Fmodel=11.2, p=0.01, r2=0.45). On the other hand, there was no significant relationship between the other variables and changes in the IL-25 levels.

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