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Allergy and Airway |

Intrasubject Variability of Total IgE Levels in Patients With Moderate to Severe Asthma and Atopy: A Prospective Study

Ahila Subramanian, MPH; Umur Hatipoglu; Timothy Campbell; Richard Rice; Mary Bossard
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Cleveland Clinic, Cleveland, OH


Chest. 2014;146(4_MeetingAbstracts):12A. doi:10.1378/chest.1967106
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Abstract

SESSION TITLE: Asthma Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: We undertook a study to delineate the magnitude of temporal change in serum IgE levels over the course of a year and its relationship to lung function, asthma control, asthma pharmacotherapy, body mass index and demographic variables in a group of patients with moderate to severe persistent asthma and atopy.

METHODS: 11 patients with chronic moderate to severe persistent asthma and history of atopy were followed for one year at 2 month intervals. In addition to baseline demographic data and pulmonary function, serum IgE levels (ImmunoCAP Total IgE, Phadia AB, Uppsala, Sweden), asthma control test score, peak expiratory flow rate, asthma pharmacotherapy, body mass index were recorded. Variability in serum IgE was explored utilizing intraclass correlation calculation and linear mixed regression model assuming 10% change in serum level as statistically significant.

RESULTS: For consecutive bimonthly visits, the mean absolute percentage change in serum IgE was 22.6% (SD=3.3%) (p= 0.001). Odds ratio of having a change greater than 10 % change in serum IgE in the subsequent visit was 2.28 (95% C.I. 1.23, 4.21, p=0.009). Intraclass correlation coefficient approached zero for change in serum IgE as outcome variable. Multivariate regression analysis did not show significant associations with baseline demographics, lung function, serial asthma control test score, peak expiratory flow rate, asthma pharmacotherapy and body mass index.

CONCLUSIONS: Serum IgE levels have significant variability over time (when determined every 2 months) among patients with moderate to severe asthma and history of atopy. Lack of association between variable studied and serum IgE level may be a consequence of inadequate sample size. Low intraclass correlation coefficient suggests that variability is mostly intrasubject and not between individuals.

CLINICAL IMPLICATIONS: Temporal variability in serum IgE levels may have phenotypical and therapeutic consequences for patients with extrinsic asthma, particularly in the context of anti-IgE treatment.

DISCLOSURE: Ahila Subramanian: Grant monies (from industry related sources): This study was conducted utilizing funds from a Novartis investigator initiated research protocol grant (Dr. Umur Hatipoglu, the recipient). The protocol of the study does not involve the use of a commercial product. Umur Hatipoglu: Grant monies (from industry related sources): This study was conducted utilizing funds from a Novartis investigator initiated research protocol grant obtained by myself. The protocol of the study does not involve the use of a commercial product. Timothy Campbell: Grant monies (from sources other than industry): This study was conducted utilizing funds from a Novartis investigator initiated research protocol grant (Dr. Umur Hatipoglu, the recipient). The protocol of the study does not involve the use of a commercial product. Richard Rice: Grant monies (from industry related sources): This study was conducted utilizing funds from a Novartis investigator initiated research protocol grant (Dr. Umur Hatipoglu, the recipient). The protocol of the study does not involve the use of a commercial product. Mary Bossard: Grant monies (from industry related sources): This study was conducted utilizing funds from a Novartis investigator initiated research protocol grant (Dr. Umur Hatipoglu, the recipient). The protocol of the study does not involve the use of a commercial product.

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