Homozygous status for the Arg16 variant is associated with increased prescribing of controller asthma medication and increased asthma-related prescribing cost

Patricia Soares (Lead / Corresponding author), Katy Fidler, Roger Tavendale, Steve Turner, Brian Lipworth, Stephen Bremner, Colin N. A. Palmer, Somnath Mukhopadhyay

Research output: Contribution to journalMeeting abstract

Abstract

Objectives: Asthma is a chronic respiratory disease, characterised by relapse and remission of symptoms. The Arg16 variant of the ADRB2 gene has been associated with diminished clinical responsiveness to β2‐agonists, and increased risk of asthma exacerbations. The association between this variant and asthma‐related prescribing is unclear. Our hypothesis is that the Arg16 allele is associated with long‐term increased use of prescribed asthma medication.

Method: A secondary analysis of BREATHE, a study of gene‐environment associations with asthma severity, was undertaken. BREATHE data were collected on participants with asthma, aged 3‐22 years, between 2003 and 2005, in Tayside and Fife, Scotland. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to several databases: Accident & Emergency, community prescribing and Scottish Morbidity Records (hospital admissions). This linkage allows exploration of associations between genetic variation and prescribing. Data between 2005 and 2013 were analysed using random effects generalised linear models.

Results: The analysis was performed on 1009 individuals. Over the 9‐year period, a significant association was found between individuals homozygous for the Arg16 variant and the prescribing of prednisolone (Gly/Arg vs Arg/Arg—Incidence Rate Ratio (IRR): 1.54, 95% CI: 1.06‐2.25; Gly/Gly vs Arg/Arg—IRR: 1.64, 95% CI: 1.12‐2.42). A significant association was also found between the Arg16 variant and prescribing of anti‐leukotriene antagonists (Gly/Gly vs Arg/Arg—IRR: 2.33, 95% CI: 1.06‐5.13) and a combination of long‐acting β2‐agonist and corticosteroids (Gly/Arg vs Arg/Arg—IRR: 2.80, 95% CI: 1.35‐5.81; Gly/Gly vs Arg/Arg—IRR: 3.15, 95% CI: 1.50‐6.63). Over the 9‐year period, children and adults with the Arg/Arg genotype cost more £250 to the NHS than children and adults with the Gly/Gly or Gly/Arg genotype.

Conclusions: Homozygous individuals with the Arg/Arg variant are associated with long‐term increased prescribing of asthma medication. Defining subgroups of individuals requiring more medication could help develop targeted management strategies.
Original languageEnglish
Article numberO.010
Pages (from-to)1681-1682
Number of pages2
JournalClinical and Experimental Allergy
Volume47
Issue number12
Early online date6 Nov 2017
DOIs
Publication statusPublished - Dec 2017

Cite this

@article{fac8451486b74a82afce618de86bd44a,
title = "Homozygous status for the Arg16 variant is associated with increased prescribing of controller asthma medication and increased asthma-related prescribing cost",
abstract = "Objectives: Asthma is a chronic respiratory disease, characterised by relapse and remission of symptoms. The Arg16 variant of the ADRB2 gene has been associated with diminished clinical responsiveness to β2‐agonists, and increased risk of asthma exacerbations. The association between this variant and asthma‐related prescribing is unclear. Our hypothesis is that the Arg16 allele is associated with long‐term increased use of prescribed asthma medication.Method: A secondary analysis of BREATHE, a study of gene‐environment associations with asthma severity, was undertaken. BREATHE data were collected on participants with asthma, aged 3‐22 years, between 2003 and 2005, in Tayside and Fife, Scotland. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to several databases: Accident & Emergency, community prescribing and Scottish Morbidity Records (hospital admissions). This linkage allows exploration of associations between genetic variation and prescribing. Data between 2005 and 2013 were analysed using random effects generalised linear models.Results: The analysis was performed on 1009 individuals. Over the 9‐year period, a significant association was found between individuals homozygous for the Arg16 variant and the prescribing of prednisolone (Gly/Arg vs Arg/Arg—Incidence Rate Ratio (IRR): 1.54, 95{\%} CI: 1.06‐2.25; Gly/Gly vs Arg/Arg—IRR: 1.64, 95{\%} CI: 1.12‐2.42). A significant association was also found between the Arg16 variant and prescribing of anti‐leukotriene antagonists (Gly/Gly vs Arg/Arg—IRR: 2.33, 95{\%} CI: 1.06‐5.13) and a combination of long‐acting β2‐agonist and corticosteroids (Gly/Arg vs Arg/Arg—IRR: 2.80, 95{\%} CI: 1.35‐5.81; Gly/Gly vs Arg/Arg—IRR: 3.15, 95{\%} CI: 1.50‐6.63). Over the 9‐year period, children and adults with the Arg/Arg genotype cost more £250 to the NHS than children and adults with the Gly/Gly or Gly/Arg genotype.Conclusions: Homozygous individuals with the Arg/Arg variant are associated with long‐term increased prescribing of asthma medication. Defining subgroups of individuals requiring more medication could help develop targeted management strategies.",
author = "Patricia Soares and Katy Fidler and Roger Tavendale and Steve Turner and Brian Lipworth and Stephen Bremner and Palmer, {Colin N. A.} and Somnath Mukhopadhyay",
year = "2017",
month = "12",
doi = "10.1111/cea.13051",
language = "English",
volume = "47",
pages = "1681--1682",
journal = "Clinical and Experimental Allergy",
issn = "0954-7894",
publisher = "Wiley",
number = "12",

}

Homozygous status for the Arg16 variant is associated with increased prescribing of controller asthma medication and increased asthma-related prescribing cost. / Soares, Patricia (Lead / Corresponding author); Fidler, Katy; Tavendale, Roger; Turner, Steve; Lipworth, Brian; Bremner, Stephen; Palmer, Colin N. A.; Mukhopadhyay, Somnath.

In: Clinical and Experimental Allergy, Vol. 47, No. 12, O.010, 12.2017, p. 1681-1682.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - Homozygous status for the Arg16 variant is associated with increased prescribing of controller asthma medication and increased asthma-related prescribing cost

AU - Soares, Patricia

AU - Fidler, Katy

AU - Tavendale, Roger

AU - Turner, Steve

AU - Lipworth, Brian

AU - Bremner, Stephen

AU - Palmer, Colin N. A.

AU - Mukhopadhyay, Somnath

PY - 2017/12

Y1 - 2017/12

N2 - Objectives: Asthma is a chronic respiratory disease, characterised by relapse and remission of symptoms. The Arg16 variant of the ADRB2 gene has been associated with diminished clinical responsiveness to β2‐agonists, and increased risk of asthma exacerbations. The association between this variant and asthma‐related prescribing is unclear. Our hypothesis is that the Arg16 allele is associated with long‐term increased use of prescribed asthma medication.Method: A secondary analysis of BREATHE, a study of gene‐environment associations with asthma severity, was undertaken. BREATHE data were collected on participants with asthma, aged 3‐22 years, between 2003 and 2005, in Tayside and Fife, Scotland. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to several databases: Accident & Emergency, community prescribing and Scottish Morbidity Records (hospital admissions). This linkage allows exploration of associations between genetic variation and prescribing. Data between 2005 and 2013 were analysed using random effects generalised linear models.Results: The analysis was performed on 1009 individuals. Over the 9‐year period, a significant association was found between individuals homozygous for the Arg16 variant and the prescribing of prednisolone (Gly/Arg vs Arg/Arg—Incidence Rate Ratio (IRR): 1.54, 95% CI: 1.06‐2.25; Gly/Gly vs Arg/Arg—IRR: 1.64, 95% CI: 1.12‐2.42). A significant association was also found between the Arg16 variant and prescribing of anti‐leukotriene antagonists (Gly/Gly vs Arg/Arg—IRR: 2.33, 95% CI: 1.06‐5.13) and a combination of long‐acting β2‐agonist and corticosteroids (Gly/Arg vs Arg/Arg—IRR: 2.80, 95% CI: 1.35‐5.81; Gly/Gly vs Arg/Arg—IRR: 3.15, 95% CI: 1.50‐6.63). Over the 9‐year period, children and adults with the Arg/Arg genotype cost more £250 to the NHS than children and adults with the Gly/Gly or Gly/Arg genotype.Conclusions: Homozygous individuals with the Arg/Arg variant are associated with long‐term increased prescribing of asthma medication. Defining subgroups of individuals requiring more medication could help develop targeted management strategies.

AB - Objectives: Asthma is a chronic respiratory disease, characterised by relapse and remission of symptoms. The Arg16 variant of the ADRB2 gene has been associated with diminished clinical responsiveness to β2‐agonists, and increased risk of asthma exacerbations. The association between this variant and asthma‐related prescribing is unclear. Our hypothesis is that the Arg16 allele is associated with long‐term increased use of prescribed asthma medication.Method: A secondary analysis of BREATHE, a study of gene‐environment associations with asthma severity, was undertaken. BREATHE data were collected on participants with asthma, aged 3‐22 years, between 2003 and 2005, in Tayside and Fife, Scotland. Through collaboration with the Health Informatics Centre in Dundee, BREATHE was linked to several databases: Accident & Emergency, community prescribing and Scottish Morbidity Records (hospital admissions). This linkage allows exploration of associations between genetic variation and prescribing. Data between 2005 and 2013 were analysed using random effects generalised linear models.Results: The analysis was performed on 1009 individuals. Over the 9‐year period, a significant association was found between individuals homozygous for the Arg16 variant and the prescribing of prednisolone (Gly/Arg vs Arg/Arg—Incidence Rate Ratio (IRR): 1.54, 95% CI: 1.06‐2.25; Gly/Gly vs Arg/Arg—IRR: 1.64, 95% CI: 1.12‐2.42). A significant association was also found between the Arg16 variant and prescribing of anti‐leukotriene antagonists (Gly/Gly vs Arg/Arg—IRR: 2.33, 95% CI: 1.06‐5.13) and a combination of long‐acting β2‐agonist and corticosteroids (Gly/Arg vs Arg/Arg—IRR: 2.80, 95% CI: 1.35‐5.81; Gly/Gly vs Arg/Arg—IRR: 3.15, 95% CI: 1.50‐6.63). Over the 9‐year period, children and adults with the Arg/Arg genotype cost more £250 to the NHS than children and adults with the Gly/Gly or Gly/Arg genotype.Conclusions: Homozygous individuals with the Arg/Arg variant are associated with long‐term increased prescribing of asthma medication. Defining subgroups of individuals requiring more medication could help develop targeted management strategies.

U2 - 10.1111/cea.13051

DO - 10.1111/cea.13051

M3 - Meeting abstract

VL - 47

SP - 1681

EP - 1682

JO - Clinical and Experimental Allergy

JF - Clinical and Experimental Allergy

SN - 0954-7894

IS - 12

M1 - O.010

ER -