Early-onset AD tied to higher risk of atopic march in children

Children with early-onset atopic dermatitis (AD) are at increased odds of developing atopic march conditions compared with those with early-onset AD, reveals a study.

The authors sought to determine the risk factors for atopic march in early-onset AD patients, as well as the temporality between AD and atopic march. They used the MarketScan Research Database to perform a retrospective cohort analysis from 2010 to 2018 and compare infants diagnosed with AD before age of 1 year (n=27,228) with controls without the said condition (n=55,174).

Finally, the authors calculated the hazard ratios (HRs) for the development of asthma, allergic rhinitis, and food allergy.

A significantly greater proportion of children with early-onset AD developed asthma (19.21 percent vs 8.65 percent; p<0.001), allergic rhinitis (28.27 percent vs 12.62 percent; p<0.001), food allergy (16.00 percent vs 2.27 percent; p<0.001), and all atopic triad conditions (10.69 percent vs 0.71 percent; p<0.001) compared with controls.

Among children with AD, those who were male (HR, 1.66, 95 percent confidence interval [CI], 1.45‒1.90), had severe disease (HR, 3.16, 95 percent CI, 2.77‒3.60), or had family atopy history (HR >3.40; p<0.001 for all comparisons) were at greater risk of developing the atopic triad. In the same group, about one in five (20.1 percent) developed allergic rhinitis.

“Particular attention should be paid toward risk factors and atopic march screening in early-onset AD patients,” the authors said.

The study was limited by its use of healthcare claims data.