Premium
Individuals with filaggrin‐related eczema and asthma have increased long‐term medication and hospital admission costs
Author(s) -
Soares P.,
Fidler K.,
Felton J.,
Tavendale R.,
Hövels A.,
Bremner S.A.,
Palmer C.N.A.,
Mukhopadhyay S.
Publication year - 2018
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.16720
Subject(s) - medicine , asthma , filaggrin , rate ratio , confidence interval , cohort , medical prescription , pediatrics , allergy , incidence (geometry) , atopic dermatitis , immunology , physics , optics , pharmacology
Summary Background Eczema and asthma are chronic diseases with onset usually before the age of 5 years. More than 50% of individuals with eczema will develop asthma and/or other allergic diseases. Several loss‐of‐function mutations in filaggrin ( FLG ) have been identified in patients with eczema. However, the association of FLG with healthcare use is unknown. Objectives To determine whether FLG mutations are associated with increased prescribing for eczema and asthma and whether increased prescribing is associated with increased healthcare costs. Methods A secondary analysis of BREATHE , a cross‐sectional study of gene–environment associations with asthma severity, was undertaken. BREATHE data was collected for 1100 participants with asthma, in Tayside and Fife, Scotland during the period 2003–2005. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to accident and emergency, community prescribing and Scottish morbidity records. The data linkage allowed longitudinal exploration of associations between genetic variation and prescribing. Results An association was found between FLG mutations and increased prescribing for mild and moderate eczema, asthma‐reliever medicine and asthma exacerbations. A strong association was found between FLG mutations and prescribing of emollients [incidence rate ratio ( IRR ) 2·19, 95% confidence interval ( CI ) 1·36–3·52], treatment for severe eczema ( IRR 2·18, 95% CI 1·22–3·91) and a combination of a long‐acting β 2 ‐agonist and corticosteroids ( IRR 3·29, 95% CI 1·68–6·43). Conclusions The presence of FLG mutations in this cohort is associated with increased prescribing for eczema and asthma. Randomized controlled trials are required to determine if these individuals could benefit from management strategies to reduce morbidity and treatment costs.