Choi Una E, Deng Junwen, Parthasarathy Varsha, Liao Viviane, D'Amiano Anjali, Taylor Matthew, Bordeaux Zachary A, Kambala Anusha, Cornman Hannah L, Canner Joseph K, Drucker Aaron M, Kwatra Shawn G
Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland.
Johns Hopkins Surgery Center for Outcomes Research, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Am Acad Dermatol. 2025 Apr;92(4):732-740. doi: 10.1016/j.jaad.2024.10.107. Epub 2024 Nov 28.
Risk factors and the temporal relationship between atopic dermatitis (AD) and atopic march remain understudied.
Determine risk factors for atopic march in early-onset AD patients and the temporality between AD and atopic march.
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.
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.
Our study was based on health care claims data.
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.
特应性皮炎（AD）与特应性进程之间的风险因素及时间关系仍研究不足。
确定早发型AD患者特应性进程的风险因素以及AD与特应性进程之间的时间关系。
我们使用市场扫描研究数据库进行2010年至2018年的回顾性队列分析，将1岁前诊断为AD的婴儿与无早发型AD的对照组进行比较。主要结局是哮喘、过敏性鼻炎和食物过敏发生的风险比（HRs）。
与55174名对照组相比，27228名AD患者中发生哮喘（19.21%对8.65%，P<.001）、过敏性鼻炎（28.27%对12.62%，P<.001）、食物过敏（16.00%对2.27%，P<.001）以及所有特应性三联征疾病（10.69%对0.71%，P<.001）的比例更高。在AD患者中，如果是男性（HR 1.66，95%置信区间[1.45 - 1.90]）、患有严重疾病（HR 3.16，[2.77 - 3.60]）或有家族特应性病史（所有比较的HR>3.40，P<.001），则发生特应性三联征的比例更高。在AD患者中，20.1%发生了过敏性鼻炎。
我们的研究基于医疗保健理赔数据。
与对照组相比，早发型AD发生特应性进程疾病的发生率更高。应特别关注早发型AD患者的风险因素和特应性进程筛查。
