Link Between Atopic Dermatitis and Increased Risk for Asthma Strengthened

A woman having trouble breathing
A woman having trouble breathing
Patients with atopic dermatitis have a greater than 25% mean prevalence of asthma, which physicians should be cognizant of and address.

Compared with the general population, patients with atopic dermatitis (AD) have a higher risk for developing asthma, according to study research published in the Journal of the American Academy of Dermatology.

The study was a meta-analysis of published English-language articles that reported data on either asthma prevalence in patients with AD or associations between asthma and AD. All studies included in the analysis featured cohort sizes of more than 50 participants. From a total of 39,503 identified articles, 213 met all inclusion criteria and were included in the quantitative analysis. Overall, there was a pooled cohort of 688,927 patients with AD and 2,223,921 reference participants.

In patients with AD and reference participants, the overall pooled prevalence of asthma was 25.7% (95% CI, 23.7-27.7) and 8.1% (95% CI, 7.0-9.4), respectively. In studies that only included physician-based diagnoses of AD and asthma, the pooled prevalence was 21.0% (95% CI, 17.9-24.3) in patients with AD (n=428,037). In studies of children with AD (n=468,096), the pooled asthma prevalence was 26.3% (95% CI, 23.5-29.1).

In 67 studies, there was an overall significant association between asthma and AD in the pooled analysis (odds ratio [OR], 3.03; 95% CI, 2.64-3.47). This association remained significant in the analysis of studies that only defined asthma as a wheeze (OR, 2.46; 95% CI, 2.08-2.90).

Limitations of the analysis were the inclusion of studies that varied in their definitions of asthma and AD as well as the inclusion of studies mostly from developed nations in the West.

The investigators from this study wrote that “it remains unknown to what extent concomitant asthma should influence AD treatment choices,” suggesting future work is needed.

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Ravnborg N, Ambikaibalan D, Agnihotri G, et al.  Prevalence of asthma in patients with atopic dermatitis: a systematic review and meta-analysis [published online February 26, 2020]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2020.02.055