MEDICAL AND ECONOMIC JUSTIFICATION OF THE TREATMENT OF BRONCHIAL ASTHMA DEPENDING ON THE POLYMORPHISM OF THE LTC4S GENE

Abstract

Summary. The difficulty of achieving and maintaining control over bronchial asthma (BA), the high prevalence of this disease and the significant costs associated with it make it necessary to improve treatment taking into account the genetic characteristics of patients. Numerous studies by various authors indicate the nucleotide polymorphism of the LTC4S gene as a strong risk factor for asthma and aspirin intolerance, which determines the severity of the disease and affects the response to treatment with leukotriene receptor antagonists.

The aim of the study – to substantiate the proposal from both a medical and economic point of view on changes in the basic scheme of treatment of bronchial asthma taking into account the polymorphism of the LTC4S gene.

Materials and Methods. The study involved 181 patients with asthma, which according to the results of genetic research were divided into three groups depending on the type of polymorphism – genotypes AA, AS and SS. Determination of allelic polymorphism of the LTC4-S -444C gene (rs 730012) was performed by polymerase chain reaction followed by restriction fragment length analysis by Gan-nan Wang et al. with modifications.

Results. Genetic study for a group of 181 patients with asthma showed the following results on the polymorphism of the gene LTC4-S -444C: genotype AA – 77 people, AС – 73 people and СС – 31 people. Based on the analysis of the practice of using the basic scheme of treatment of asthma, an approach is proposed, which is based on the use of different treatment regimens for patients depending on the polymorphism of the LTC4-S-444C gene. Both medical and economic substantiation (with the corresponding calculations of cost of treatment per 1 patient) of the offer are resulted.

Conclusions. The calculations showed that under the conditions of the basic scheme of treatment the average cost per patient is 229 USD, and under the conditions of the proposed one – 184 USD. Also, the proposal to change the treatment regimen increases the accuracy of diagnosis, accelerates the improvement of the patient's condition, ie leads to improved quality of life.