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Humans , Male , Female , Communication Barriers , Asthma/epidemiology , Asthma/prevention & control , Health Knowledge, Attitudes, Practice , Practice Management, Medical/organization & administration , Surveys and Questionnaires , Attitude to Health , Practice Management, Medical/standardsABSTRACT
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Humans , Male , Female , Asthma/epidemiology , Asthma/immunology , Asthma/prevention & control , Monitoring, Immunologic/methods , Health Care Coordination and Monitoring , Indicators of Health Services/organization & administration , Indicators of Health Services/statistics & numerical data , Indicators of Quality of Life , Health Status Indicators , Quality Indicators, Health Care/trendsABSTRACT
Objectives: To evaluate the association between serum total IgE levels and disease severity in adult patients with persistent allergic asthma and to explore the main predictors of IgE levels. Methods: We performed a multicenter, retrospective, observational study including adult patients diagnosed ≥1 year previously with persistent allergic asthma who were positive to ≥1 allergen. Patients also had serum total IgE and spirometry results available from the previous 12 months. Inclusion was stratified by asthma severity according to the GEMA 2009 criteria. Results: We included 383 patients with allergic asthma (129 mild, 82 moderate, and 172 severe). Mean (SD) age was 38 (15), 46 (16), and 45 (15) years, respectively (P400 IU/mL (36% vs 26.4% [mild] and 18.3% [moderate], P=.010). In a multivariate multiple regression model, the independent predictors of higher IgE were younger age (P=.004), sensitization to ≥2 allergens (P=.009), male gender (P=.025), and family history of asthma (P=.122). Conclusion: Serum total IgE levels in adult patients with persistent allergic asthma were high (two-thirds with levels >150 IU/mL) and extremely variable. We did not find a significant association between serum total IgE levels and asthma severity or airflow limitation, except for a higher percentage of patients with IgE >400 IU/mL in the severe subgroup (AU)
Objetivos: Evaluar la asociación entre los niveles séricos de IgE total y la gravedad de la enfermedad en adultos con asma alérgica persistente, y explorar los principales factores predictores de los niveles de IgE total. Métodos: Estudio multicéntrico, observacional, retrospectivo que incluyó pacientes adultos diagnosticados de asma alérgica persistente al menos de un año de evolución, con positividad para ≥1 alérgeno, y que dispusieran de resultados de IgE sérica total y espirometría de los últimos 12 meses. Se estratificó la inclusión según la gravedad del asma, de acuerdo a los criterios GEMA 2009. Resultados: Se incluyeron 383 pacientes con asma alérgica, 129 leve, 82 moderada y 172 grave, con una edad media (DE) de 38 (15), 46 (16) y 45 (15) años, respectivamente (p400 UI/mL (36% frente a 26,4% (leve ) y 18,3% (moderada) ,P=0,010). En un modelo de regresión múltiple multivariante, los predictores independientes de niveles más elevados de IgE fueron: una menor edad (P=0,004); la sensibilización a ≥2 alérgenos (P=0,009); el sexo masculino (P=0,025) y los antecedentes familiares de asma (P=0,122). Conclusión: Los niveles séricos de IgE total en pacientes adultos con asma alérgica persistente fueron elevados (dos tercios con niveles >150 UI/mL) y extremadamente variables, y no se asociaron a la gravedad del asma ni a la limitación del flujo aéreo, a excepción de un mayor porcentaje de pacientes con IgE>400 UI/mL en el asma grave (AU)
