Ammara Ahmed1, S Christy Sadreameli2, Jean Curtin-Brosnan1, Torie Grant1, Wanda Phipatanakul3, Matthew Perzanowski4, Susan Balcer-Whaley1, Roger Peng5, Michelle Newman1, Amparito Cunningham3, Adnan Divjan4, Mary E Bollinger6, Robert A Wise7, Rachel Miller8, Ginger Chew4, Elizabeth C Matsui9. 1. Division of Pediatric Allergy/Immunology, Johns Hopkins University School of Medicine, Baltimore, Md. 2. Division of Pediatric Pulmonology, Johns Hopkins University School of Medicine, Baltimore, Md. 3. Division of Pediatric Allergy/Immunology, Boston Children's Hospital, Harvard University Medical School, Boston, Mass. 4. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY. 5. Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md. 6. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md. 7. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. 8. Division of Pulmonary, Allergy and Critical Care Medicine, College of Physicians and Surgeons, Columbia University, New York, NY. 9. Department of Population Health and Pediatrics, Dell Medical School at the University of Texas, Austin, Tex. Electronic address: Elizabeth.matsui@austin.utexas.edu.
Abstract
BACKGROUND: Mouse allergen reduction is associated with improvements in asthma among sensitized and exposed children, but whether clinical characteristics predict responsiveness to allergen reduction is unclear. OBJECTIVE: To examine the effects of clinical characteristics on relationships between mouse allergen reduction and asthma outcomes. METHODS: We performed a secondary analysis of data from a randomized clinical trial of a mouse allergen intervention, examining the effects of atopy, demographic characteristics, lung function, asthma control, and asthma severity on relationships between mouse allergen reduction and asthma outcomes. RESULTS:Participants were predominantly low-income and minority (78% black, 22% Hispanic), and had persistent asthma. Among less atopic participants (<6 positive skin prick test results), each 50% reduction in mouse allergen was associated with fewer symptoms (incidence rate ratio [95% CI]: maximal symptoms: 0.94 [0.92-0.96]). There was little effect of mouse allergen reduction on symptoms among more atopic participants (P > .05). The interactions between atopic status and mouse allergen reduction were statistically significant for all symptom outcomes; however, there was no evidence that atopic status influenced the effect of mouse allergen reduction on exacerbation-related outcomes. Older children (≥9 years) tended to experience greater improvement in some asthma outcomes with reduction in mouse allergen exposure than younger children. There was no evidence that either mouse-specific IgE or lung function influenced the effect of mouse allergen reduction on any asthma outcomes. CONCLUSIONS: Although there may be variability in the clinical response to mouse allergen reduction among low-income, minority children with asthma, there were no clinical characteristics that clearly identified a subgroup at which the intervention should be targeted.
RCT Entities:
BACKGROUND:Mouse allergen reduction is associated with improvements in asthma among sensitized and exposed children, but whether clinical characteristics predict responsiveness to allergen reduction is unclear. OBJECTIVE: To examine the effects of clinical characteristics on relationships between mouse allergen reduction and asthma outcomes. METHODS: We performed a secondary analysis of data from a randomized clinical trial of a mouse allergen intervention, examining the effects of atopy, demographic characteristics, lung function, asthma control, and asthma severity on relationships between mouse allergen reduction and asthma outcomes. RESULTS:Participants were predominantly low-income and minority (78% black, 22% Hispanic), and had persistent asthma. Among less atopic participants (<6 positive skin prick test results), each 50% reduction in mouse allergen was associated with fewer symptoms (incidence rate ratio [95% CI]: maximal symptoms: 0.94 [0.92-0.96]). There was little effect of mouse allergen reduction on symptoms among more atopic participants (P > .05). The interactions between atopic status and mouse allergen reduction were statistically significant for all symptom outcomes; however, there was no evidence that atopic status influenced the effect of mouse allergen reduction on exacerbation-related outcomes. Older children (≥9 years) tended to experience greater improvement in some asthma outcomes with reduction in mouse allergen exposure than younger children. There was no evidence that either mouse-specific IgE or lung function influenced the effect of mouse allergen reduction on any asthma outcomes. CONCLUSIONS: Although there may be variability in the clinical response to mouse allergen reduction among low-income, minority children with asthma, there were no clinical characteristics that clearly identified a subgroup at which the intervention should be targeted.
Authors: Elizabeth C Matsui; Matthew Perzanowski; Roger D Peng; Robert A Wise; Susan Balcer-Whaley; Michelle Newman; Amparito Cunningham; Adnan Divjan; Mary E Bollinger; Shuyan Zhai; Ginger Chew; Rachel L Miller; Wanda Phipatanakul Journal: JAMA Date: 2017-03-14 Impact factor: 56.272
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Authors: S Christy Sadreameli; Ammara Ahmed; Jean Curtin-Brosnan; Matthew S Perzanowski; Wanda Phipatanakul; Susan Balcer-Whaley; Adnan Divjan; Roger D Peng; Michelle Newman; Amparito Cunningham; Mary E Bollinger; Robert A Wise; Rachel L Miller; Elizabeth C Matsui Journal: J Allergy Clin Immunol Pract Date: 2021-09-08