Inflammatory diseases encompass a number of conditions which are caused by an over-reaction of the immune system to environmental substances that are generally harmless. There are different mechanisms at play in these reactions, and type 2 inflammatory diseases include conditions which affect many parts of the body such as the skin (atopic dermatitis, prurigo nodularis, bullous pemphigoid, chronic spontaneous urticaria, chronic inducible urticaria), the airway system (asthma, chronic obstructive pulmonary disease, chronic rhinosinusitis with or without nasal Polyps), and the gastrointestinal system (eosinophilic esophagitis). Due to the common mechanisms, patients with one condition may be at increased likelihood of developing another condition.
Although many people suffer from inflammatory diseases, there is little data on exactly how many people are currently affected with one or several co-existing type 2 inflammatory diseases in the United Kingdom. Data is also lacking on the impact of treating patients with these conditions on the healthcare system at general practices and in hospital. In this study, we aim to first quantify the number of patients diagnosed with type 2 inflammatory diseases noted above (singly or in combination) in the United Kingdom; and second to estimate the associated healthcare resource use and cost based on English data. This study will provide insights on the current burden of allergic disease and may be used by public health policy makers to improve patients’ healthcare management and improve their access to suitable treatment.
Inflammatory diseases manifest by a disproportionate response of the immune system to an allergen. A common cause is via subpopulations of CD4+ T helper 2 cells (Th2) which stimulate type 2 immune responses and can affect various parts of the body including the skin (atopic dermatitis, prurigo nodularis, bullous pemphigoid, chronic spontaneous urticaria, chronic inducible urticaria), the airway system (asthma, chronic obstructive pulmonary disease, chronic rhinosinusitis with/without nasal polyps), and the gastrointestinal system (eosinophilic esophagitis). Hinging on common biological mechanisms, patients with one condition may have increased risk of developing another condition. There is currently little data on the prevalence of one or multiple co-existing type 2 inflammatory diseases in the United Kingdom (UK), and on the associated burden on routine primary and secondary care settings in terms of healthcare resource use (HCRU) and cost. In this study, we aim to first quantify the prevalence of type 2 inflammatory diseases noted above in the UK using the Clinical Practice Research Database (CPRD); and second to estimate the associated HCRU and cost in English CPRD linked to Hospital Episode Statistics (HES). The point prevalence of each condition, and of multiple co-existing diseases will be estimated on 1st January 2019, i.e. prior to the onset of the COVID-19 pandemic which impacted patients’ access to care. HCRU during the calendar year 2019 in patients with one or combinations of these diseases will be described including primary care contacts (general practitioner, nurse or other healthcare professional contacts) and prescribing from CPRD; and secondary care visits from HES (inpatient admissions, outpatient visits, and Accident and Emergency visits). This study will provide insights on the current burden of single and co-existing inflammatory disease in the UK, and may be used by public health policy makers to improve patients’ healthcare management and access to suitable treatment.
Asthma; chronic obstructive pulmonary disease; atopic dermatitis; prurigo nodularis; chronic urticaria; bullous pemphigoid; chronic rhinosinusitis (total and with/without nasal polyps); eosinophilic esophagitis; type 2 asthma (sensitivity analysis); type 2 chronic obstructive pulmonary disease (sensitivity analysis); HCRU related to these conditions (primary care visits, telephone consultations and prescribing costs; secondary care outpatient visits, inpatient hospitalisations and accident and emergency visits) and associated costs
Craig Currie - Chief Investigator - Pharmatelligence Limited t/a Human Data Sciences
Teresa Carroll - Corresponding Applicant - OPEN Health Group
Bethany Levick - Collaborator - Harvey Walsh Ltd
David Heaton - Collaborator - Harvey Walsh Ltd
Habeeda Rashid - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Leah Fisher - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Mark McCormack - Collaborator - Harvey Walsh Ltd
Michael Ogbechie - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Myriam Alexander - Collaborator - Harvey Walsh Ltd
Nick Denholm - Collaborator - Harvey Walsh Ltd
Ololade Oshin - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Ross Thomas - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Xiaocong Marston - Collaborator - Harvey Walsh Ltd
Bethany Levick - Collaborator - OPEN Health Group
Gillian Hall - Collaborator - Gillian Hall Epidemiology Ltd
Ololade Oshin - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Michael Ogbechie - Collaborator - Sanofi Aventis UK Holdings Limited (UK)
Nick Denholm - Collaborator - OPEN Health Group
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient