ABSTRACT
PURPOSE: Across Hong Kong, Malaysia, the Philippines, Singapore, Thailand and Vietnam, (referred to as Asia) approximately 30-53 million individuals of the 151 million employed suffer from allergic rhinitis (AR) and urticaria. It is estimated that approximately 90% of patients with these allergic conditions are insufficiently treated, impacting the socioeconomic burden in terms of absence from work and decreased productivity. This study aims to estimate the socioeconomic burden of allergies in Asia and the cost savings that their adequate management can provide. Due to the limited availability of regional data, this study focused AR and urticaria in selected countries. METHODS: Published literature, information from statistical bureaus, clinician surveys and extrapolation of selected data from the European Union were used to determine the socioeconomic costs of AR and urticaria. RESULTS: Many patients in Asia suffer from perennial allergies and experience symptoms of AR and urticaria for up to 298 days per year. An estimate of the indirect costs of patients insufficiently treated for AR and urticaria amounts to USD 105.4 billion a year, which equates to USD 1,137-2,195 per patient due to absenteeism and presenteeism. Adherence to guideline-approved treatment can lead to estimated savings of up to USD 104 billion. CONCLUSIONS: The current study suggests that within Asia, the socioeconomic impact of AR and urticaria is similar to that seen in the European Union in spite of the lower wages in Asia. This is due to the mainly perennial allergens prevailing in Asia, whereas the sensitization patterns observed in the European Union are dominated by seasonal exposure to pollen. These results underline the need for governmental initiatives to increase public awareness on the prevention and treatment of these and other allergic diseases as well as greater research funding and large-scale studies to reduce their growing socioeconomic burden in coming years.
ABSTRACT
BACKGROUND: Certain factors are known to cause exacerbation of atopic dermatitis (AD), e.g. soap, detergent, dry skin, staphylococcal colonization, and herpes infection. Other factors are suspected, but not yet proven, e.g. yeasts belonging to the Malassezia genus. It is known that antimycotics may be beneficial in a small subset of adult patients with dermatitis affecting the head and neck region; however, it is not known whether AD patients, many of whom also have head and neck involvement, may also find antimycotics useful. A previous study has demonstrated no treatment difference in adult AD patients; however, the measurement method was criticized and 1% hydrocortisone cream may have too weak an effect in adult patients. Therefore, we designed this randomized, double-blind, controlled trial to examine this question. Younger AD patients were recruited and different methods of measuring outcomes were used. OBJECTIVE: To evaluate the usefulness of topical antimycotic treatment as adjuvant therapy for flexural AD. Methods This was a randomized, double-blind, controlled trial in AD patients using one side of the elbow or knee as a control. There were three independent outcomes: (i) to compare the ability to relieve symptoms; (ii) to compare the ability to improve clinical signs; and (iii) to compare the ability to provide lasting clinical effects. RESULTS: All three outcomes showed unequivocally that the addition of antimycotic did not provide extra benefit to the standard treatment. CONCLUSION: The addition of antimycotic does not seem to provide extra benefit to AD patients, and the beneficial effect of this medication seems to be restricted to a small subset of adult patients with dermatitis affecting the head and neck region.