Risk factors and temporal associations of progression of the atopic march in children with early-onset atopic dermatitis - 19/12/24

Doi : 10.1016/j.jaad.2024.10.107

Una E. Choi, MD ^a, Junwen Deng, MD ^a, Varsha Parthasarathy, MD ^a, Viviane Liao, BA ^a, Anjali D'Amiano, BA ^a, Matthew Taylor, MD ^a, Zachary A. Bordeaux, MD ^a, Anusha Kambala, MD ^a, Hannah L. Cornman, MD ^a, Joseph K. Canner, MHS ^b, Aaron M. Drucker, MD ^c,^d, Shawn G. Kwatra, MD ^a,^e,^⁎
^a Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland
^b Johns Hopkins Surgery Center for Outcomes Research, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
^c Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
^d Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
^e Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland

^∗Correspondence to: Shawn G. Kwatra, MD, Joseph W. Burnett Professor and Chair, Department of Dermatology, University of Maryland School of Medicine, Office: 419 West Redwood St, Baltimore, MD 21201.Department of DermatologyUniversity of Maryland School of MedicineOffice: 419 West Redwood StBaltimoreMD21201

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 19 December 2024

Abstract

Background

Risk factors and the temporal relationship between atopic dermatitis (AD) and atopic march remain understudied.

Objective

Determine risk factors for atopic march in early-onset AD patients and the temporality between AD and atopic march.

Methods

We used the MarketScan Research Database for our retrospective cohort analysis from 2010 to 2018, comparing infants diagnosed with AD before age 1 with controls without early-onset AD. Primary outcomes were hazard ratios (HRs) for the development of asthma, allergic rhinitis, and food allergy.

Results

Compared to 55,174 controls, higher proportions of the 27,228 AD patients developed asthma (19.21% vs 8.65%, P < .001), allergic rhinitis (28.27% vs 12.62%, P < .001), food allergy (16.00% vs 2.27%, P < .001), and all atopic triad conditions (10.69% vs 0.71%, P < .001). Among AD patients, higher proportions developed the atopic triad if they were male (HR 1.66, 95% confidence interval [1.45-1.90]), had severe disease (HR 3.16, [2.77-3.60]), or had family atopy history (HR > 3.40, P < .001 for all comparisons). Among AD patients, 20.1% developed allergic rhinitis.

Limitations

Our study was based on health care claims data.

Conclusion

Early-onset AD is associated with higher rates of developing atopic march conditions compared to controls. Particular attention should be paid toward risk factors and atopic march screening in early-onset AD patients.

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Key words : allergic, atopic dermatitis, atopic march, eczema, pediatric

Abbreviations used : AD, C-section, HR, ICD

Esquema

	Drs Choi and Deng designates co-first authors with equal contribution.
	Drs Drucker and Kwatra designates co-senior authors.
	Funding sources: This work was funded by Pfizer. The content is solely the responsibility of the authors and does not necessarily represent the official views of Pfizer. No sponsor or funding organization was involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
	Patient consent: Not applicable.
	IRB approval status: Waived.