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Risk of atopic dermatitis and the atopic march paradigm in children of mothers with atopic illnesses: A birth cohort study from the United Kingdom - 10/02/24

Doi : 10.1016/j.jaad.2023.11.013 
Zelma C. Chiesa Fuxench, MD, MSCE a, Nandita Mitra, PhD b, Domenica Del Pozo, BA c, Ole Hoffstad, MS a, Daniel B. Shin, PhD a, David J. Margolis, MD, PhD a, b,
a Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 
b Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 
c Temple University School of Medicine, Philadelphia, Pennsylvania 

Correspondence to: David J. Margolis, MD, PhD, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, 901 Blockley, 423 Guardian Drive, Philadelphia, PA 19104.Department of Biostatistics, Epidemiology and InformaticsPerelman School of MedicineUniversity of Pennsylvania901 Blockley423 Guardian DrivePhiladelphiaPA19104

Abstract

Background

Atopic dermatitis (AD) is thought to precede the onset of other allergic illness (OAI) in a temporal progression (ie, atopic march), yet the timing and progression has been questioned. It is also unclear how parental allergic illness impacts the development of these illnesses in offspring.

Objective

(1) Explore risk of incident AD and (2) timing of allergic disease onset in children of mothers with AD compared with mothers without AD from the United Kingdom.

Methods

We created a birth cohort of mother-child pairs using IQVIA Medical Research Data database and developed Cox proportional models to examine the above associations (hazard ratio, HR [95% confidence interval, CI]).

Results

Among 1,224,243 child-mother pairs, mean child (standard deviation) follow-up time was 10.8 (8.3) years and 50.1% were males (N = 600,905). Children were 59% (HR = 1.59 [1.57, 1.60]) more likely to have AD if their mothers had AD compared with no AD with mean age of first AD diagnosis at 3.3 (4.8) years. Most children with any diagnosis of AD present with AD first (91.0%); however, in those with asthma, only 67.8% developed AD first.

Conclusion

Children born to mothers with AD are more prone to develop AD and some develop OAI first, suggesting that not all follow the same sequential pathway.

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Capsule Summary

The atopic march describes the temporal association of initial onset of atopic dermatitis at an early age followed by subsequent development of other atopic illness.
We observed that whereas this may be true for some, not all patients with allergic diseases including atopic dermatitis, will follow the same “sequential” march.

Le texte complet de cet article est disponible en PDF.

Key words : administrative database, asthma, atopic dermatitis, atopic march, eczema, epidemiology, seasonal allergies

Abbreviations used : AD, FLG LOF, HR, IMRD, OAI


Plan


 Funding sources: Supported by the Penn Skin Biology and Diseases Resource-based Center, funded by NIH/NIAMS grant P30-AR069589 (Core C: to D.J.M.) and the University of Pennsylvania Perelman School of Medicine.
 IRB approval status: Approved by IMRD, Scientific Review Committee for UK Ethics as protocol number 22SRC042, and University of Pennsylvania Institutional Review Board.
 Patient consent: Not applicable.
 Data Availability Statement: The data used for this study were made available for this study only. Researchers interested in access to the protocol and programming code should reach out to the corresponding author and for access to the raw data contact IQVIA Medical Research Data.


© 2023  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 90 - N° 3

P. 561-568 - mars 2024 Retour au numéro
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