Atopic dermatitis increases risk for inflammatory bowel disease

Both children and adults with atopic dermatitis have an increased risk for inflammatory bowel disease (IBD), according to a study published online Aug. 30 in JAMA Dermatology.

Zelma C. Chiesa Fuxench, M.D., from University of Pennsylvania in Philadelphia, and colleagues examined the association of atopic dermatitis with the risk for ulcerative colitis and Crohn disease. The analysis included more than 1.8 million pediatric controls matched to 409,431 children with atopic dermatitis (93.2 percent mild, 5.5 percent moderate, and 1.3 percent severe) and close to 2.7 million adult controls matched to 625,083 adults with atopic dermatitis (65.7 percent mild, 31.4 percent moderate, and 2.9 percent severe).

The researchers found that in fully adjusted models, children with atopic dermatitis had an increased risk for IBD (hazard ratio [HR], 1.44; 95 percent confidence interval [CI], 1.31 to 1.58) and Crohn disease (HR, 1.74; 95 percent CI, 1.54 to 1.97), which increased with worsening atopic dermatitis. However, children with atopic dermatitis did not have an overall increased risk for ulcerative colitis (HR, 1.09; 95 percent CI, 0.94 to 1.27), although those with severe atopic dermatitis did (HR, 1.65; 95 percent CI, 1.02 to 2.67). For adults with atopic dermatitis, there was an increased risk for IBD (HR, 1.34; 95 percent CI, 1.27 to 1.40), Crohn disease (HR, 1.36; 95 percent CI, 1.26 to 1.47), and ulcerative colitis (HR, 1.32; 95 percent CI, 1.24 to 1.41), with the risk increasing with worsening atopic dermatitis.

"Clinicians should be aware of these risks, particularly when selecting systemic treatments for atopic dermatitis in patients who may have coincident gastrointestinal symptoms," write the authors.

Several authors disclosed ties to the pharmaceutical and biopharmaceutical industries.

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