Atopic dermatitis: disease characteristics and comorbidities in smoking and non-smoking patients from the TREATgermany registry.
Journal
Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
15
09
2021
received:
08
07
2021
accepted:
22
10
2021
pubmed:
8
11
2021
medline:
19
2
2022
entrez:
7
11
2021
Statut:
ppublish
Résumé
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. In this study, AD characteristics and its atopic comorbidities are compared in smoking and non-smoking AD patients. TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included in TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analysed comparing AD disease characteristics and comorbidities in smokers vs. non-smokers. Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n = 352; 38.8%) and non-smokers, however, lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to non-smoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than non-smokers. Total IgE levels were more elevated in smokers and they displayed a younger age at the initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to non-smokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet. German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
Sections du résumé
BACKGROUND
BACKGROUND
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke.
OBJECTIVES
OBJECTIVE
In this study, AD characteristics and its atopic comorbidities are compared in smoking and non-smoking AD patients.
METHODS
METHODS
TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included in TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analysed comparing AD disease characteristics and comorbidities in smokers vs. non-smokers.
RESULTS
RESULTS
Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n = 352; 38.8%) and non-smokers, however, lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to non-smoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than non-smokers. Total IgE levels were more elevated in smokers and they displayed a younger age at the initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to non-smokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet.
CONCLUSIONS
CONCLUSIONS
German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
413-421Subventions
Organisme : LEO Pharma GmbH
Organisme : Sanofi-Aventis Deutschland GmbH
Organisme : Lilly Deutschland GmbH
Organisme : Galderma SA
Informations de copyright
© 2021 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
Références
Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann. Nutr Metab 2015; 66(suppl 1): 8-16.
Bylund S, von Kobyletzki LB, Svalstedt M, Svensson Å. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol 2020; 100: adv00160.
Barbarot S, Auziere S, Gadkari A et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy 2018; 73: 1284-1293.
Ring J, Zink A, Arents BWM et al. Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults. J Eur Acad Dermatol Venereol 2019; 33: 1331-1340.
Linnet J, Jemec GB. An assessment of anxiety and dermatology life quality in patients with atopic dermatitis. Br J Dermatol 1999; 140: 268-272.
Dalgard FJ, Gieler U, Tomas-Aragones L et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol 2015; 135: 984-991.
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1859-1922.
Ehlken B, Möhrenschlager M, Kugland B, Berger K, Quednau K, Ring J. [Cost-of-illness study in patients suffering from atopic eczema in Germany]. Hautarzt 2005; 56: 1144-1151.
Weidinger S, Novak N. Atopic dermatitis. Lancet 2016; 387: 1109-1122.
Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol 2003; 112(6 Suppl): S118-S127.
Paller AS, Spergel JM, Mina-Osorio P, Irvine AD. The atopic march and atopic multimorbidity: many trajectories, many pathways. J Allergy Clin Immunol 2019; 143: 46-55.
Eyerich K, Eyerich S, Biedermann T. The multi-modal immune pathogenesis of atopic eczema. Trends Immunol 2015; 36: 788-801.
Eyerich S, Eyerich K, Traidl-Hoffmann C, Biedermann T. Cutaneous barriers and skin immunity: differentiating a connected network. Trends Immunol 2018; 39: 315-327.
Bonamonte D, Filoni A, Vestita M, Romita P, Foti C, Angelini G. The role of the environmental risk factors in the pathogenesis and clinical outcome of atopic dermatitis. Biomed Res Int 2019; 2019: 2450605.
Schäfer T, Dirschedl P, Kunz B, Ring J, Überla K. Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring. J Am Acad Dermatol 1997; 36: 550-556.
Krämer U, Lemmen CH, Behrendt H et al. The effect of environmental tobacco smoke on eczema and allergic sensitization in children. Br J Dermatol 2004; 150: 111-118.
Kantor R, Kim A, Thyssen JP, Silverberg JI. Association of atopic dermatitis with smoking: a systematic review and meta-analysis. J Am Acad Dermatol 2016; 75: 1119-25.e1.
Kim SY, Sim S, Choi HG. Atopic dermatitis is associated with active and passive cigarette smoking in adolescents. PLoS One 2017; 12: e0187453.
Lee CH, Chuang HY, Hong CH et al. Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br J Dermatol 2011; 164: 483-489.
Kim YS, Kim HY, Ahn HS et al. The association between tobacco smoke and serum immunoglobulin E levels in Korean adults. Intern Med 2017; 56: 2571-2577.
Zetterström O, Osterman K, Machado L, Johansson SG. Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy. Br Med J 1981; 283: 1215-1217.
Plaschke PP, Janson C, Norrman E, Björnsson E, Ellbjär S, Järvholm B. Onset and remission of allergic rhinitis and asthma and the relationship with atopic sensitization and smoking. Am J Respir Crit Care Med 2000; 162(3 Pt 1): 920-924.
Skaaby T, Taylor AE, Jacobsen RK et al. Investigating the causal effect of smoking on hay fever and asthma: a Mendelian randomization meta-analysis in the CARTA consortium. Sci Rep 2017; 7: 2224.
Heratizadeh A, Haufe E, Stölzl D et al. Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2020; 34: 1263-1272.
Abraham S, Haufe E, Harder I et al. Implementation of dupilumab in routine care of atopic eczema: results from the German national registry TREATgermany. Br J Dermatol 2020; 183: 382-384.
Ingordo V, D’Andria G, D’Andria C. Adult-onset atopic dermatitis in a patch test population. Dermatology 2003; 206: 197-203.
Jamal A, Agaku IT, O'Connor E, King BA, Kenemer JB, Neff L. Current cigarette smoking among adults-United States, 2005-2013. MMWR Morb Mortal Wkly Rep 2014; 63: 1108-1112.
Broms U, Silventoinen K, Lahelma E, Koskenvuo M, Kaprio J. Smoking cessation by socioeconomic status and marital status: the contribution of smoking behavior and family background. Nicotine Tob Res 2004; 6: 447-455.
Pisoni RL, Wikström B, Elder SJ et al. Pruritus in haemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2006; 21: 3495-3505.
Matterne U, Apfelbacher CJ, Vogelgsang L, Loerbroks A, Weisshaar E. Incidence and determinants of chronic pruritus: a population-based cohort study. Acta Derm Venereol 2013; 93: 532-537.
Oweis AO, Al-Qarqaz F, Bodoor K et al. Elevated interleukin 31 serum levels in hemodialysis patients are associated with uremic pruritus. Cytokine 2021; 138: 155369.
Kimata N, Fuller DS, Saito A et al. Pruritus in hemodialysis patients: Results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS). Hemodial Int 2014; 18: 657-667.
Shnawa BH, Al-Ali SJ, Ahmad HF, Essa SA. An investigative study of smoking effect on IL-31 levels and leukocyte differential counts in humans. Ann Trop Med Public Health 2020; 23: 23-1133.
Lai YC, Yew YW. Smoking and hand dermatitis in the United States adult population. Ann Dermatol 2016; 28: 164-171.
Gupta MA, Gupta AK, Watteel GN. Cigarette smoking in men may be a risk factor for increased severity of psoriasis of the extremities. Br J Dermatol 1996; 135: 859-860.
Aicher A, Heeschen C, Mohaupt M, Cooke JP, Zeiher AM, Dimmeler S. Nicotine strongly activates dendritic cell-mediated adaptive immunity: potential role for progression of atherosclerotic lesions. Circulation 2003; 107: 604-611.
Izzotti A, Cartiglia C, Longobardi M et al. Alterations of gene expression in skin and lung of mice exposed to light and cigarette smoke. FASEB J 2004; 18: 1559-1561.
Rossi M, Pistelli F, Pesce M et al. Impact of long-term exposure to cigarette smoking on skin microvascular function. Microvasc Res 2014; 93: 46-51.
Hatoum OA, Binion DG, Otterson MF, Gutterman DD. Acquired microvascular dysfunction in inflammatory bowel disease: loss of nitric oxide-mediated vasodilation. Gastroenterology 2003; 125: 58-69.
Wüthrich B, Schindler C, Medici TC, Zellweger JP, Leuenberger P. IgE levels, atopy markers and hay fever in relation to age, sex and smoking status in a normal adult Swiss population. Int Arch Allergy Immunol 1996; 111: 396-402.
Jarvis D, Luczynska C, Chinn S, Burney P. The association of age, gender and smoking with total IgE and specific IgE. Clin Exp Allergy 1995; 25: 1083-1091.
Amaral AFS, Newson RB, Abramson MJ et al. Changes in IgE sensitization and total IgE levels over 20 years of follow-up. J Allergy Clin Immunol 2016; 137: 1788-95.e9.
Grillo C, La Mantia I, Grillo CM, Ciprandi G, Ragusa M, Andaloro C. Influence of cigarette smoking on allergic rhinitis: a comparative study on smokers and non-smokers. Acta Biomed 2019; 90(7-s): 45-51.
Polosa R, Knoke JD, Russo C et al. Cigarette smoking is associated with a greater risk of incident asthma in allergic rhinitis. J Allergy Clin Immunol 2008; 121: 1428-1434.
Rasmussen F, Siersted HC, Lambrechtsen J, Hansen HS, Hansen NC. Impact of airway lability, atopy, and tobacco smoking on the development of asthma-like symptoms in asymptomatic teenagers. Chest 2000; 117: 1330-1335.
Polosa R, Russo C, Caponnetto P et al. Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study. Respir Res 2011; 12: 16.
Bjerg-Bäcklund A, Perzanowski MS, Platts-Mills T, Sandström T, Lundbäck B, Rönmark E. Asthma during the primary school ages-prevalence, remission and the impact of allergic sensitization. Allergy 2006; 61: 549-555.
Gilliland FD, Islam T, Berhane K et al. Regular smoking and asthma incidence in adolescents. Am J Respir Crit Care Med 2006; 174: 1094-1100.
Hackshaw A, Morris JK, Boniface S, Tang J-L, Milenković D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ 2018; 360: j5855.
Gellert C, Schöttker B, Müller H, Holleczek B, Brenner H. Impact of smoking and quitting on cardiovascular outcomes and risk advancement periods among older adults. Eur J Epidemiol 2013; 28: 649-658.
Mons U, Müezzinler A, Gellert C et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium. Br Med J 2015; 350: h1551.
Kawachi I, Colditz GA, Stampfer MJ et al. Smoking cessation in relation to total mortality rates in women. A prospective cohort study. Ann Intern Med 1993; 119: 992-1000.
Duncan MS, Freiberg MS, Greevy RA, Jr, Kundu S, Vasan RS, Tindle HA. Association of smoking cessation with subsequent risk of cardiovascular disease. JAMA 2019; 322: 642-650.
Honjo K, Iso H, Tsugane S et al. The effects of smoking and smoking cessation on mortality from cardiovascular disease among Japanese: pooled analysis of three large-scale cohort studies in Japan. Tobacco Control 2010; 19: 50-57.