Evaluation of drug use health related quality of life and pharmacoeconomics in autoimmune skin disorders: focus on blistering skin disorders-a prospective observational study

Authors

  • Deshna H. Lad Department of Pharmacology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Ashish Jagati Department of Dermatology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Pooja Agarwal Department of Dermatology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Supriya D. Malhotra Department of Pharmacology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20214506

Keywords:

ASDs, AIBDs, Percentage variation in cost, QoL, Steroids

Abstract

Background: Autoimmune skin disorders (ASDs) are complex diseases triggered by autoantibodies action against epidermal antigens or the dermo epidermal junction. Although rare, they present high morbidity, affecting the quality of life (QoL) of patients and financial status of patient.

Methods: This prospective, observational study was carried out in department of dermatology for 2-3 months after ethical approval. Drug usage pattern, heath related QoL (HRQOL) by using DLQI (Dermatology life quality index) and cost were evaluated in patients with ASDs. Statistical analysis was done using Microsoft excel office 2019 and rechecked with SPSS (version 23.0). P<0.001 was considered as statistically significant.

Results: Out of 73 patients enrolled, 32 were male and 41 were female with the mean age was 48.27±14.93 years; 55% patients had autoimmune blistering skin disorders (AIBDs) and 45% having other ASDs (OADs). Pemphigus vulgaris (PV) (35%) being the most common among all ASDs. Systemic steroid (60.27%), topical steroid (79.45%), levocetirizine (63%) were most commonly prescribed drugs. Mean DLQI score at baseline and after treatment was 11.64±2.49 and 6.8±2.75 respectively. It was highly significant statistically (p<0.0001). Total cost of illness per month was 813.64±481.21 INR. Maximum percentage variation in cost was seen with prednisolone (1706.28%).

Conclusions: ASDs have a female bias and inflict severe impairment to the QoL of patients. Appropriate drug therapy with corticosteroids and other adjuvant drug lead to positive impact on QoL. There was very wide price variation of different brands of the same generic most commonly prednisolone and levocetirizine.

References

Diya M. Therapy of autoimmune bullous diseases. Therapeutics clin risk management. 2007;3;29-40.

Penha MA, Farat JG, Miot HA, Barraviera SRCS Quality of life index in autoimmune bullous dermatosis patients. An Bras Dermatol. 2015;90(2):190-4.

Bertram F, Bröcker EB, Zillikens D, Schmidt E. Prospective analysis of the incidence of autoimmune bullous disorders in Lower Franconia, Germany. J Dtsch Dermatol Ges. 2009;7:434-40.

Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJ, West J. Bullous pemphigoid and pemphigus vulgaris-incidence and mortality in the UK: population-based cohort study. BMJ. 2008;337:a180.

Cunha PR, Barraviera SRCS. Autoimmune bullous dermatoses. An Bras Dermatol. 2009;84:111-24.

Chellet R, Oakley A, Derm GM. Autoimmune diseases in dermatology. DermNetZ. 2019.

Autoimmune Blistering Disorders Medically Reviewed by Stephanie S. Gardner. 2020.

Harman KE, Albert S, Black MM: Guidelines for the management of pemphigus vulgaris. Br J Dermatol 2003;149:926-37.

Mutasim DF. Therapy of autoimmune bullous diseases. Ther Clin Risk Manag. 2007;3(1):29-40.

Penha MA, Farat JG, Miot HA, Barraviera SRCS Quality of life index in autoimmune bullous dermatosis patients. An Bras Dermatol. 2015;90(2):190-4.

Sebaratnam DF, McMillan JR, Werth VP, Murrell DF. Quality of life in patients with bullous dermatoses. Clin Dermatol. 2012;30:103-7.

Basra MK, Fenech R, Gatt RM, Salek MS and Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008;159:997-1035.

Hongbo Y, Thomas CL, Harrison MA, Salek MS and Finlay AY. Translating the science of quality of life into practice: What do dermatology life quality index scores mean? J Invest Dermatol. 2005;125:659-64.

Jadhav NB, Bhosale MS, Adhav CV. Cost Analysis Study of Oral Antidiabetic Drugs Available in Indian Market. Int J Med Res Health Sci. 2013;2(1):63-9.

Souza SR, Azulay-Abulafia L, Nascimento LV. Validation of the commitment index of skin and mucous membranes in pemphigus vulgaris for the clinical evaluation of patients with pemphigus vulgaris. An Bras Dermatol. 2011;86:284-91.

Kasperkiewicz M, Ellebrecht CT, Takahashi H. Pemphigus. Nat Rev Dis Primers. 2017;3:17026.

Zhao CY, Murrell DF. Autoimmune blistering diseases in females: a review. Int J Womens Dermatol. 2015;1(1):4-12.

Ahmed SA, Penhale WJ. The influence of testosterone on the development of autoimmune thyroiditis in thymectomized and irradiated rats. Clin Exp Immunol. 1982;48(2):367-74.

Calippe B, Douin-Echinard V, Laffargue M. Chronic estradiol administration in vivo promotes the proinflammatory response of macrophages to TLR4 activation: involvement of the phosphatidylinositol 3-kinase pathway. J Immunol. 2008;180(12):7980-8.

World Health Organization Quality of Life Assessment (WHOQoL) Position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9.

Sebaratnam DF, McMillan JR, Werth VP, Murrell DF. Quality of life in patients with bullous dermatoses. Clin Dermatol. 2012;30(1):103-7.

Rencz F, Gulacsi L, Tamasi B, Karpati S, Pentek M, Baji P. Health-related quality of life and its determinants in pemphigus: a systematic review and meta-analysis. Br J Dermatol. 2015;173(4):1076-80.

Sung JY, Roh MR, Kim SC. Quality of Life Assessment in Korean Patients with Pemphigus. Ann Dermatol. 2015;27(5):492-8.

Herbst A, Bystryn JC. Patterns of remission in pemphigus vulgaris. J Am Acad Dermatol. 2000;42:422-7.

Ioannides D, Chrysomallis F, Bystryn JC. Ineffectiveness of cyclosporin as an adjuvant to corticosteroids in the treatment of pemphigus. Arch Dermatol. 2000;136:868-72.

Jena M, Panda M, Patro N, Mishra S. Pattern of utilization of corticosteroids in department of dermatology at a tertiary care teaching hospital. J Chem Pharmaceut Res. 2014;6(8):86-91.

Bylappa BK, Patil RT, Pillai RT. Drug prescribing pattern of topical corticosteroids in dermatology unit of a tertiary-care hospital. Int J Med Sci Public Health. 2015;4.

Manju, Saravanam R, Balan S, Menon R, David BG. Study of prescribing pattern of topical corticosteroids in dermatology outpatient department in a Tertiary Care Hospital in Puducherry. Int J Pharmacol Res. 2018;8(1):01-5.

Jhanwar A, Sharma N. Cost analysis and price variation of commonly used drugs in obstetrics and gynecology in Jhalawar district of Rajasthan, India. Int J Basic Clin Pharmacol 2018;7.

Ray A, Najmi A, Khandelwal G, Sadasivam B. A Cost Variation Analysis of Drugs Available in the Indian Market for the Management of Thromboembolic Disorders. Cureus. 2020;12(5):e7964.

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Published

2021-11-22

How to Cite

Lad, D. H., Jagati, A., Agarwal, P., & Malhotra, S. D. (2021). Evaluation of drug use health related quality of life and pharmacoeconomics in autoimmune skin disorders: focus on blistering skin disorders-a prospective observational study. International Journal of Basic & Clinical Pharmacology, 10(12), 1398–1404. https://doi.org/10.18203/2319-2003.ijbcp20214506

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Original Research Articles