Atopic Dermatitis in Children Is Associated With Greater Asthma Risk

Investigators of a study in The Journal of Allergy and Clinical Immunology: In Practice reported that children with atopic dermatitis (AD) are at a greater risk of asthma, as well as asthma exacerbations and hospitalization.

In order to determine the risk of asthma, asthma exacerbations, and asthma-related hospitalizations among patients with AD, the investigators designed a retrospective cohort study. The study, which spanned the years of 1994 to 2015, involved the analysis of electronic health records data from UK general practices. Researchers focused on both children (<18 years old) and adults (>18 years) with AD, categorizing AD severity based on treatments and dermatologist referrals. These individuals were then matched with patients without AD based on age, practice, and index date.

The cohort study included 409,341 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) compared with 1,809,029 children without AD. The analysis revealed that AD in children was associated with a significant, 2-fold greater risk of developing asthma compared with those without AD (hazard ratio [HR], 1.96; 95% CI, 1.93-1.98).

Similarly, among 625,083 adults with AD (65.7% mild, 31.4% moderate, 2.9% severe) compared against 2,678,888 unaffected adults, AD was associated with a 38% higher risk of asthma (HR, 1.38; 95% CI, 1.36-1.40).

The study does have its limitations, however. First, the study relied on electronic health records, and the accuracy and completeness of those records may vary. There might be underreporting or misclassification of AD or asthma cases, potentially leading to biased results. Additionally, the study covers a long period of time, during which there may have been changes in diagnostic criteria, treatment approaches, and other health care practices that could impact the results.

“Risk of asthma and subsequent asthma-related exacerbation and hospitalization increases with the presence and severity of AD, especially in children. Those with more severe AD may benefit from increased attention to control of their asthma,” the investigators wrote.