Onset of Atopic Comorbidities Relative to Atopic Dermatitis Diagnosis in a Real-World Setting Using an Israeli Claims Database

Patients with atopic dermatitis (AD) often have other comorbidities, which can include asthma, allergic rhinitis and food allergies. Using an Israeli health care provider database, investigators sought out to discern whether these often-associated conditions begin before or after the AD diagnosis.

Researchers conducted a retrospective cohort study using the Maccabi Healthcare Services database in Israel of 2.5 million members. Patients diagnosed with AD during 2000-2019 were identified, based on the International Classification of Diseases, 9th revision, diagnosis codes. Patients had to have been enrolled for 12 months or more, pre-index, to exclude prevalent AD. Diagnosis data was obtained during 1998-2020 to describe cumulative prevalence of asthma, allergic rhinitis, and food allergies both before and after their AD diagnosis, using Kaplan-Meier analysis among patients aged less than 3, 3 to 5, 6 to 11, 12 to 17, and 18 years or older at the time of diagnosis.

The study included 243,687 patients, nearly 52% who were female with AD. Median age at diagnosis was 4.3 years; 43.9% and 72.7% of patients were diagnosed before age 3 and 18 years, respectively.

At diagnosis time, 28.1% had a prior or concurrent diagnosis of asthma/allergic rhinitis/food allergy. Of patients aged less than 3 years, 16.2% has been diagnosed with one of these associated conditions at the time of AD diagnosis. In the youngest age group, the cumulative prevalence of the 3 comorbidities were 28.8%, 42.7%, 49.6% and 59.6% within 1, 5, 10 and 20 years post-AD diagnosis.

In adults with AD, 37.7% had been diagnosed with asthma/allergic rhinitis/food allergies at the time they were diagnosed with AD. The cumulative prevalence of asthma/allergic rhinitis/food allergies were 40.3%, 46.1%, 50.9%, and 57.6% within 1, 5, 10, and 20 years post-AD diagnosis.

Investigators concluded that this real-world analysis was consistent with previous evidence that AD is primarily a childhood-onset disorder. However, regardless of age at AD diagnosis, nearly 60% of these patients were estimated to have equal to or greater than 1 diagnosis of asthma/allergic rhinitis/food allergies within 20 years of their diagnosis of AD.

Reference

Leshem Y, Becker A, Busse WW, et al. Onset of atopic comorbidities relative to atopic dermatitis diagnosis in a real-world setting using an Israeli claims database. Abstract presented at: RAD 2022 Conference; December 11, 2022. https://djbpnesxepydt.cloudfront.net/radv/December2022/Dec2022Abstracts/323_RWE-Atopic-Journey_Leshem-et-al_Abstract_1670529276697.pdf