Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Retrospective markers of paediatric atopic dermatitis persistence after hospital diagnosis: A nationwide cohort study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Identifying and managing patients at risk of severe allergic reactions to food: Report from two iFAAM workshops

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Bronchoscopic mucosal cryobiopsies as a method for studying airway disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Advancing the management of Obstructive Airways Diseases through Translational Research

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Determinants of low risk of asthma exacerbation during pregnancy

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Clinical Relevance of Skin Pain in Atopic Dermatitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Impact of Atopic Dermatitis Lesion Location on Quality of Life in Adult Patients in a Real-world Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Management of Ocular Manifestations of Atopic Dermatitis: A Consensus Meeting Using a Modified Delphi Process

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Cost of Treating Skin Problems in Patients with Diabetes who Use Insulin Pumps and/or Glucose Sensors

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Efficacy and Safety of Abrocitinib in Patients With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Atopic dermatitis (AD) normally onsets in childhood and mostly resolves before adolescences. Disease persistence is known to be difficult to study properly, and current predictors are insufficient to identify more than a small fraction of patients at risk.

OBJECTIVE: To study personal AD medicine history as a retrospective marker of persistent AD.

METHODS: The study population included all Danish first hospital contacts with a diagnosis of AD (ICD-10, L20) between 1995 and 2012. National register data following the diagnosis were used to define persistent AD activity until 2017 according to personal AD medicine history before diagnosis. Activity was defined as filled prescriptions for topical corticosteroids (TCS) or calcineurin inhibitors (TCI), dermatologist contacts or hospital re-contacts for AD. Risk ratios (RR) for persistent activity (defined as activity >4 of the most recent 5 years) were estimated according to AD medicine history (prescriptions filled prior to diagnosis) adjusted for age at onset, parental AD and basic covariates.

RESULTS: A total of 13 628 patients were diagnosed at ages 0-16 years and had up to 21 years of follow-up. 10 years after diagnosis, 67% showed activity (9.5% persistent). Among prior TCS users (69%), the RR10y of persistent activity increased 1- to 6-fold with increasing strength of strongest TCS/TCI ever, and with number of TCS courses. Prior use of antibiotics (RR10y 1.32, 95% CI 1.09-1.59) and antihistamines (RR10y 1.65, 95% CI 1.42-1.91) increased the RR10y in a dose-dependent manner. In >90% of patients, prior medication use occurred <4 years before diagnosis.

CONCLUSIONS AND CLINICAL RELEVANCE: The strength and type of AD medication used in the previous 4 years may predict 10-year persistence of AD. Since children may be misjudged as having milder disease when seen between flares of skin lesions, this information may improve physicians' ability to determine the correct prognosis independently of current AD severity.

Original languageEnglish
JournalClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
Volume49
Issue number11
Pages (from-to)1455-1463
Number of pages9
ISSN0954-7894
DOIs
Publication statusPublished - Nov 2019

ID: 58985774