Gender differences in IgE-mediated allergic asthma in the epidemiology and natural history of asthma: Outcomes and treatment regimens (TENOR) study

Background. The TENOR study consists of a large cohort of subjects with severe or difficult-to-treat asthma. The objective of this analysis was to evaluate demographic and clinical characteristics of subjects 12 years of age or older with immunoglobulin E (IgE)-mediated allergic asthma ( skin test positive with an IgE level >= 30 to <= 700 IU/mL), and specifically, to assess gender differences in this cohort. Methods. A total of 4,756 subjects were enrolled by 283 US study sites between January and October 2001. Of those subjects 12 years or older at baseline with an IgE measure and who were skin tested (n=2,843), 1,783 (63%) were skin test positive and had an IgE level between >= 30 to <= 700 IU/mL. Results. Compared to males, females reported significantly greater healthcare utilization ( steroid bursts in previous 3 months: 50% vs 42%, p<0.001; unscheduled office visits in previous 3 months: 50% vs 36%, p<0.0001; missed 1+ days of work/school in previous 2 weeks: 14% vs 10%, p<0.01). Females also reported significantly more asthma control problems and lower asthma-related quality of life (4.6 +/- 1.3 vs 5.2 +/- 1.2; p<0.0001); the difference was clinically meaningful. Asthma triggers and allergic comorbidities, such as allergic rhinitis and atopic dermatitis, were more common in female subjects. Despite their overall worse health outcomes, female subjects demonstrated better lung function, had similar treatment patterns, and showed no differences in physician-assessed asthma severity when compared with males. Conclusions. The reasons for these gender differences in subjects with IgE-mediated allergic asthma are complex, but results from this analysis suggest that detailed evaluations of asthma patients, including symptom-related questions and asthma-related healthcare utilization, are needed to accurately assess asthma severity and control.