Modest increase in risk of death with AD

Adults with atopic dermatitis have a marginally increased risk of all-cause death compared with disease-free adults. Examination of a Danish nationwide health care database and patient and cause of death registries uncovered a 27 percent increased risk of death due to any cause in the atopic dermatitis cohort over a 5-year follow-up period.

The findings were reported by Danish investigators in the March 2018 Journal of the American Academy of Dermatology.

Using the Danish Civil Registration System and the National Patient Registry, the investigators identified 8,686 adults with a diagnosis of atopic dermatitis matched to 86,860 controls. The National Causes of Death Registry was used to attribute the deaths. Over 5 years of follow-up, the mortality rate was 5.79 percent among the atopic dermatitis patients compared with 4.69 percent among the matched controls, a significant 27 percent difference. The incidence ratios of cardiovascular death (1.45), death due to infectious disease (3.71), and death with urogenital disease as a cause (5.51) were all significantly higher in the atopic dermatitis cohort.

The finding of a slightly increased risk of death due to cardiovascular disease is consistent with other studies demonstrating an increased rate of cardiovascular disease among patients with atopic dermatitis, the authors noted. “An important discussion point has been the explanation for this apparent increase, with some studies speculating that AD could represent an independent risk factor for cardiovascular disease and other studies suggesting that cardiovascular risk factors associated with atopic dermatitis would explain this risk,” they wrote. “Although our study was not designed to examine that particular question, our mortality data shows that the clinical effect of a putatively increased cardiovascular disease risk among atopic dermatitis patients is quite modest.”

Given the finding, assessment of cardiovascular risk factors in the atopic dermatitis patient population is prudent, they advised.

The increased risk of death due to infectious disease and urogenital disease was based on few cases.

REFERENCE

Jacob P. Thyssen, Lone Skov and Alexander Egeberg. "Cause-specific mortality in adults with atopic dermatitis," JAAD. Published online November 1, 2017.  https://doi.org/10.1016/j.jaad.2017.10.032