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Are filaggrin mutations associated with increased prescribing for eczema and asthma, and is increased prescribing associated with increased healthcare costs? 

Eczema and asthma are chronic diseases with onset usually before the age of five years. More than 50 per cent of individuals with eczema will develop asthma and/or other allergic diseases. Several loss‐of‐function mutations in filaggrin have been identified in patients with eczema. However, the association of filaggrin with healthcare use is unknown.

A study sought to determine whether filaggrin mutations are associated with increased prescribing for eczema and asthma and whether increased prescribing is associated with increased healthcare costs.

A secondary analysis of BREATHE, a cross‐sectional study of gene–environment associations with asthma severity, was undertaken. BREATHE data was collected for 1,100 participants with asthma in 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.

An association was found between filaggrin mutations and increased prescribing for mild and moderate eczema, asthma‐reliever medicine and asthma exacerbations. A strong association was found between filaggrin 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 β2‐agonist and corticosteroids (IRR 3·29, 95% CI 1·68–6·43).

The study concluded that the presence of filaggrin mutations in this cohort is associated with increased prescribing for eczema and asthma.

It noted that randomised controlled trials are required to determine if these individuals could benefit from management strategies to reduce morbidity and treatment costs.

Read more recent research on eczema.

Source: Soares, P. , Fidler, K. , Felton, J. , Tavendale, R. , Hövels, A. , Bremner, S. , Palmer, C. and Mukhopadhyay, S. (2018), Individuals with filaggrin‐related eczema and asthma have increased long‐term medication and hospital admission costs. Br J Dermatol, 179: 717-723. doi:10.1111/bjd.16720

Interested in General Dermatology?

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