Early-Onset Atopic Dermatitis Linked to Increased Risk of Atopic March: Study Identifies Key Risk Factors
USA: A recent study has found that early-onset atopic dermatitis (AD), diagnosed before the age of one, is linked to a heightened risk of asthma (19.21%), allergic rhinitis (28.27%), and food allergies (16%). Additionally, the study revealed that 10.69% of patients with AD went on to develop the full atopic triad, comprising asthma, rhinitis, and food allergy.
Key risk factors contributing to the progression of AD to the atopic march included male gender, severe AD, and a family history of atopy. The findings published in the Journal of the American Academy of Dermatology emphasize the importance of early identification and management of AD to mitigate its broader health impacts.
The relationship between atopic dermatitis (AD), the progression to the atopic march, and the associated risk factors remains insufficiently explored. For this purpose, Shawn G. Kwatra, Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, and colleagues aimed to identify the risk factors for the atopic march in patients with early-onset AD and examine the temporal association between AD and the development of the atopic march.
For this purpose, the researchers utilized the MarketScan Research Database to conduct a retrospective cohort analysis spanning 2010 to 2018. They compared infants diagnosed with atopic dermatitis (AD) before the age of one to a control group without early-onset AD.
The primary outcomes of interest were hazard ratios (HR) for developing asthma, allergic rhinitis, and food allergy.
The study led to the following findings:
- Among 27,228 AD patients compared to 55,174 controls, higher proportions developed asthma (19.21% versus 8.65%), allergic rhinitis (28.27% versus 12.62%), food allergy (16.00% versus 2.27%), and all atopic triad conditions (10.69% versus 0.71%).
- Male AD patients were more likely to develop the atopic triad (HR 1.66).
- Severe AD significantly increased the likelihood of the atopic triad (HR 3.16).
- A family history of atopy was associated with a greater than threefold risk of the atopic triad (HR >3.40).
- Among AD patients, 20.1% developed allergic rhinitis.
The study, based on healthcare claims data, highlights that early-onset atopic dermatitis (AD) is associated with significantly higher rates of developing conditions within the atopic march compared to controls.
"These findings emphasize the importance of focusing on risk factors and implementing proactive screening strategies for the atopic march in patients with early-onset AD," the researchers concluded.
Reference:
Choi, U. E., Deng, J., Parthasarathy, V., Liao, V., D'Amiano, A., Taylor, M., Bordeaux, Z. A., Kambala, A., Cornman, H. L., Canner, J. K., Drucker, A. M., & Kwatra, S. G. (2024). Risk factors and temporal associations of progression of the atopic march in children with early-onset dermatitis. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2024.10.107
