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Impact of high baseline Aspergillus-specific IgG levels on weight and quality-of-life outcomes of patients with chronic pulmonary aspergillosis.
Medical Mycology ( IF 2.9 ) Pub Date : 2020-04-28 , DOI: 10.1093/mmy/myaa026 Felix Bongomin 1 , Tomaz Garcez 2 , David W Denning 3, 4
Medical Mycology ( IF 2.9 ) Pub Date : 2020-04-28 , DOI: 10.1093/mmy/myaa026 Felix Bongomin 1 , Tomaz Garcez 2 , David W Denning 3, 4
Affiliation
This study aimed to evaluate the impact of quantitative baseline Aspergillus-specific immunoglobulin G (IgG) serum levels on weight changes of patients with chronic pulmonary aspergillosis (CPA) under antifungal treatment. We retrospectively reviewed data of patients diagnosed with CPA between April 2015 and March 2018 at the National Aspergillosis Centre (Manchester, UK). All patients were on continued antifungal treatment for 12 months. Data on Aspergillus-specific IgG levels, St George's quality of life (SGQoL) variables and weight at baseline, 6 months and 12 months were extracted. We defined a high serum Aspergillus-specific IgG as ≥ 200 mg/l (Group A) and low level < 200 mg/l (Group B). Forty-nine patients (37 male; 12 female), median age 65 years (range: 29–86) were studied. Overall, 33% (n = 16) of the patients were in Group A. The baseline characteristics between the two groups were similar. The median Charlson comorbidity index was 4 (range: 0–5) and 3 (range: 0–9) for Group A and Group B, respectively (P = .543). There was a sustained decline in median Aspergillus IgG levels from baseline, through 6 month to 12 months of continues therapy from 170 (range: 20–1110) to 121 (range: 20–1126), and finally 107 (15–937) mg/l, respectively (P < .001). Group A patients gained more weight at 6 months (9/15 [60%] vs. 7/33 [21%], P = .012) and at 12 months of treatment (9/15 [60%] vs. 7/33 [22%]), and more patients in Group B lost weight ((13/33 [41%] vs. 1/15 [7%]), P = .015). However, there was no difference in QoL outcomes across groups at 6 (P = .3) and 12 (P = .7) months. A very high Aspergillus IgG may confer a higher likelihood of weight gain as a key, objective marker of clinical response, if patients can tolerate 12 months of antifungal therapy.
中文翻译:
高基线曲霉特异性IgG水平对慢性肺曲霉病患者体重和生活质量结局的影响。
这项研究旨在评估基线抗曲霉菌治疗的慢性曲霉病(CPA)患者体重基线曲霉菌特异性免疫球蛋白G(IgG)血清水平对体重变化的影响。我们回顾了2015年4月至2018年3月在英国曼彻斯特国家曲霉病中心诊断为CPA的患者的数据。所有患者均接受持续的抗真菌治疗12个月。提取有关曲霉菌特异性IgG水平,圣乔治生活质量(SGQoL)变量和基线,6个月和12个月体重的数据。我们定义了高血清曲霉特异性IgG≥200 mg / l(A组),低水平<200 mg / l(B组)。研究对象为四十九名患者(男37例;女12例),中位年龄65岁(范围:29-86)。总体而言,A组中有33%(n = 16)的患者。两组之间的基线特征相似。A组和B组的中位Charlson合并症指数分别为4(范围:0-5)和3(范围:0-9)(P = .543)。从基线到持续治疗的6个月至12个月中曲霉菌IgG中位数持续下降,从170(范围:20-1110)降至121(范围:20-1126),最后是107(15-937)mg / l(P <.001)。A组患者在6个月时体重增加(9/15 [60%]与7/33 [21%],P = 0.012)和在治疗12个月时(9/15 [60%]对7/33 [22%]),B组中的体重减轻的患者更多((13/33 [41%]对1 / 15 [7%]),P = .015)。然而,在6个月(P = .3)和12 个月(P = .7)时,各组的QoL结局均无差异。如果患者可以耐受12个月的抗真菌治疗,那么很高的曲霉IgG可能会增加体重增加的可能性,这是临床反应的关键客观指标。
更新日期:2020-04-28
中文翻译:
高基线曲霉特异性IgG水平对慢性肺曲霉病患者体重和生活质量结局的影响。
这项研究旨在评估基线抗曲霉菌治疗的慢性曲霉病(CPA)患者体重基线曲霉菌特异性免疫球蛋白G(IgG)血清水平对体重变化的影响。我们回顾了2015年4月至2018年3月在英国曼彻斯特国家曲霉病中心诊断为CPA的患者的数据。所有患者均接受持续的抗真菌治疗12个月。提取有关曲霉菌特异性IgG水平,圣乔治生活质量(SGQoL)变量和基线,6个月和12个月体重的数据。我们定义了高血清曲霉特异性IgG≥200 mg / l(A组),低水平<200 mg / l(B组)。研究对象为四十九名患者(男37例;女12例),中位年龄65岁(范围:29-86)。总体而言,A组中有33%(n = 16)的患者。两组之间的基线特征相似。A组和B组的中位Charlson合并症指数分别为4(范围:0-5)和3(范围:0-9)(P = .543)。从基线到持续治疗的6个月至12个月中曲霉菌IgG中位数持续下降,从170(范围:20-1110)降至121(范围:20-1126),最后是107(15-937)mg / l(P <.001)。A组患者在6个月时体重增加(9/15 [60%]与7/33 [21%],P = 0.012)和在治疗12个月时(9/15 [60%]对7/33 [22%]),B组中的体重减轻的患者更多((13/33 [41%]对1 / 15 [7%]),P = .015)。然而,在6个月(P = .3)和12 个月(P = .7)时,各组的QoL结局均无差异。如果患者可以耐受12个月的抗真菌治疗,那么很高的曲霉IgG可能会增加体重增加的可能性,这是临床反应的关键客观指标。