Retrospective markers of paediatric atopic dermatitis persistence after hospital diagnosis: A nationwide cohort study.
Administration, Topical
Adolescent
Adrenal Cortex Hormones
/ administration & dosage
Biomarkers
/ metabolism
Calcineurin Inhibitors
/ administration & dosage
Child
Child, Preschool
Denmark
/ epidemiology
Dermatitis, Atopic
/ diagnosis
Female
Humans
Infant
Infant, Newborn
Male
Registries
Retrospective Studies
Risk Factors
atopic dermatitis
children
epidemiology
paediatrics
persistence
Journal
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
ISSN: 1365-2222
Titre abrégé: Clin Exp Allergy
Pays: England
ID NLM: 8906443
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
19
06
2019
revised:
20
08
2019
accepted:
21
08
2019
pubmed:
30
8
2019
medline:
18
9
2020
entrez:
30
8
2019
Statut:
ppublish
Résumé
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. To study personal AD medicine history as a retrospective marker of persistent AD. 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. 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 RR 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.
Sections du résumé
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 RR
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.
Substances chimiques
Adrenal Cortex Hormones
0
Biomarkers
0
Calcineurin Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1455-1463Informations de copyright
© 2019 John Wiley & Sons Ltd.
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