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The Identify Project: Do We Know the Most Prevalent Allergens in Severe Asthma?
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A2493 - The Identify Project: Do We Know the Most Prevalent Allergens in Severe Asthma?
Author Block: J. Schreiber1, C. Mailaender2; 1Respiratory Diseases, Universitiy Hospital, Magdeburg, Germany, 2Novartis Pharma Germany, Nuernberg, Germany.
Rationale
About 10% of all asthmatics suffer from severe allergic asthma, which is frequently caused by IgE hypersensitivity against perennial and/or seasonal allergens. Evaluation of these allergic sensitizations is required for the treatment of severe asthma. However, allergy testing is often limited, e.g. within the German reimbursement system, testing of only 8 allergens per quarter is paid for by health insurances. Moreover, there is no clear alignment about the most frequent sensitizations found in severe asthmatics.
The aim of this ongoing project is to gain data on sensitizations towards aeroallergens in severe asthmatic patients, in which no allergen had been detected in previous “limited” testings and who were therefore considered non-atopic.
Methods35 local perennial aeroallergens (mites, fungi, animal epithelia and insects) are measured by specific IgE assessment in 600 severe asthmatic patients in Germany who had negative results in previous allergen tests by either Skin Prick Test or analyses of specific IgE. Furthermore, total IgE levels are determined and a general anamnesis is documented.
ResultsIn a subgroup of 268 patients analysed with Siemens Immulite® (62.4 % females, mean age 55.9 y), 54.9 % demonstrated at least one sensitization towards a perennial aeroallergen despite them being considered non-atopic before. Overall, the three most common sensitizations were found towards Staphylococcus aureus Enterotoxin B and A (30.9 % and 17.0 %) and R. nigricans (18.9 %). In patients being S. aureus enterotoxin positive (n=68), 50% were polysensitized towards ≥4 other specific IgE’s tested compared to only 19% in the S. aureus negative group (n=120).
The majority of the patients (83.6 %) were (partly) uncontrolled according to GINA classification and 52.1 % had ≥2 exacerbations in the past 12 months. Approximately one third (37.3%) is receiving oral corticosteroids as maintenance therapy on top of inhaled corticosteroids and long-acting ß-agonists (ICS/LABA).
Conclusion
These results indicate inadequate diagnosis of sensitization towards aeroallergens in severe asthmatic patients. This suggests that the percentage of allergic asthmatics might be underestimated. The meaning of a sensitization towards S. aureus enterotoxins A and B in severe asthmatics needs to be further evaluated. However, the correct ascertainment of the allergic status is crucial to make optimal treatment decisions.
2.500 characters incl spaces allowed (current: 2467)
Author Block: J. Schreiber1, C. Mailaender2; 1Respiratory Diseases, Universitiy Hospital, Magdeburg, Germany, 2Novartis Pharma Germany, Nuernberg, Germany.
Rationale
About 10% of all asthmatics suffer from severe allergic asthma, which is frequently caused by IgE hypersensitivity against perennial and/or seasonal allergens. Evaluation of these allergic sensitizations is required for the treatment of severe asthma. However, allergy testing is often limited, e.g. within the German reimbursement system, testing of only 8 allergens per quarter is paid for by health insurances. Moreover, there is no clear alignment about the most frequent sensitizations found in severe asthmatics.
The aim of this ongoing project is to gain data on sensitizations towards aeroallergens in severe asthmatic patients, in which no allergen had been detected in previous “limited” testings and who were therefore considered non-atopic.
Methods35 local perennial aeroallergens (mites, fungi, animal epithelia and insects) are measured by specific IgE assessment in 600 severe asthmatic patients in Germany who had negative results in previous allergen tests by either Skin Prick Test or analyses of specific IgE. Furthermore, total IgE levels are determined and a general anamnesis is documented.
ResultsIn a subgroup of 268 patients analysed with Siemens Immulite® (62.4 % females, mean age 55.9 y), 54.9 % demonstrated at least one sensitization towards a perennial aeroallergen despite them being considered non-atopic before. Overall, the three most common sensitizations were found towards Staphylococcus aureus Enterotoxin B and A (30.9 % and 17.0 %) and R. nigricans (18.9 %). In patients being S. aureus enterotoxin positive (n=68), 50% were polysensitized towards ≥4 other specific IgE’s tested compared to only 19% in the S. aureus negative group (n=120).
The majority of the patients (83.6 %) were (partly) uncontrolled according to GINA classification and 52.1 % had ≥2 exacerbations in the past 12 months. Approximately one third (37.3%) is receiving oral corticosteroids as maintenance therapy on top of inhaled corticosteroids and long-acting ß-agonists (ICS/LABA).
Conclusion
These results indicate inadequate diagnosis of sensitization towards aeroallergens in severe asthmatic patients. This suggests that the percentage of allergic asthmatics might be underestimated. The meaning of a sensitization towards S. aureus enterotoxins A and B in severe asthmatics needs to be further evaluated. However, the correct ascertainment of the allergic status is crucial to make optimal treatment decisions.
2.500 characters incl spaces allowed (current: 2467)
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