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Prevalence of type 2 inflammatory diseases in pediatric patients with atopic dermatitis: Real-world evidence
Amy S Paller1, Paola Mina-Osorio2, Francis Vekeman3
1Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
Pediatric patients with atopic dermatitis (AD) have a substantially higher risk of developing other type 2 inflammatory diseases, including asthma and eosinophilic esophagitis. This highlights the need for better AD management and treatment strategies.
Area of Science:
- Immunology
- Pediatrics
- Epidemiology
Background:
- Atopic dermatitis (AD) is linked to increased risk of type 2 inflammatory diseases.
- Limited real-world data exists for pediatric populations in the U.S.
Purpose of the Study:
- Assess the prevalence and incidence of type 2 inflammatory diseases in U.S. pediatric patients with AD.
- Utilize a large, commercially insured population for robust evidence.
Main Methods:
- Matched 1:1 analysis of pediatric patients with and without AD using IBM MarketScan (2013-2017).
- Assessed prevalence of conditions like asthma, rhinitis, and urticaria 12 months post-index.
- Examined incidence of type 2 diseases in younger children (0-2 years).
Main Results:
- Over 244,000 patients analyzed; higher prevalence and incidence of type 2 diseases in AD patients.
- Prevalence of asthma, eosinophilic esophagitis, urticaria, and rhinitis more than doubled.
- Disease burden increased with atopic dermatitis severity.
Conclusions:
- Pediatric patients with AD face a significant burden of associated type 2 inflammatory diseases.
- Optimizing AD management is crucial to address comorbidities.
- Further research needed to understand and mitigate these risks.
Background:
Patients with atopic dermatitis (AD) are considered at increased risk of developing other type 2 inflammatory diseases. However, real-world evidence based on large commercially insured pediatric populations in the United States is scarce.
Objective:
To use a large claims database (IBM MarketScan 2013-2017) in the United States to assess prevalence and incidence of type 2 inflammatory diseases in pediatric patients with AD.
Methods:
Pediatric patients with AD were matched 1:1 to patients without AD. Prevalence was assessed for conjunctivitis, rhinitis, urticaria, asthma, eosinophilic esophagitis, and chronic rhinosinusitis/nasal polyps at the 12 months' post-index date (the first AD diagnosis date for patients with AD; a randomly selected outpatient visit for control patients). The incidence of other type 2 inflammatory diseases post-index was assessed among patients 0-2 years of age.
Results:
A total of 244,776 AD and matched non-AD patients were selected. The prevalence and incidence of type 2 inflammatory diseases were higher among patients with AD. Overall, the prevalence more than doubled for asthma, eosinophilic esophagitis, urticaria, and rhinitis, and increased with AD severity.
Limitations:
AD identification was based on billing diagnoses; the observation period was only 12 months; and the study was limited to commercially insured patients.
Conclusion:
The burden of type 2 inflammatory diseases in pediatric patients with AD is substantial, highlighting the need to optimize management of AD and its numerous associated morbidities.
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