Evaluating the Longitudinal Course of Atopic Dermatitis: Implications for Clinical Practice

Chovatiya, Raj; Silverberg, Jonathan I.

doi:10.1007/s40257-022-00697-w

Cited by 14 publications

(10 citation statements)

References 104 publications

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“…The longitudinal course of eczema is not routinely incorporated into clinical management, practice guidelines or clinical trial design. 1 Over the last 5 years, there has been a developing literature on the clustering of longitudinal data on eczema, using data-driven approaches (summarized in Table S1 ; see Supporting Information ). 2–10 In most studies, repeated information on the presence or absence of current eczema was modelled to derive classes (phenotypes), mostly using latent class analysis (LCA).…”

mentioning

confidence: 99%

Identification of eczema clusters and their association with filaggrin and atopic comorbidities: analysis of five birth cohorts

Haider,

Granell,

Curtin

et al. 2023

British Journal of Dermatology

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Background Longitudinal modelling of the presence/absence of current eczema through childhood has identified similar phenotypes, but their characteristics often differ between studies. Objectives To demonstrate that a more comprehensive description of longitudinal pattern of symptoms may better describe trajectories than binary information on eczema presence. Methods We derived six multidimensional variables of eczema spells from birth to 18 years of age (including duration, temporal sequencing and the extent of persistence/recurrence). Spells were defined as consecutive observations of eczema separated by no eczema across 5 epochs in five birth cohorts: infancy (first year); early childhood (age 2–3 years); preschool/early school age (4–5 years); middle childhood (8–10 years); adolescence (14–18 years). We applied Partitioning Around Medoids clustering on these variables to derive clusters of the temporal patterns of eczema. We then investigated the stability of the clusters, within-cluster homogeneity and associated risk factors, including FLG mutations. Results Analysis of 7464 participants with complete data identified five clusters: (i) no eczema (51.0%); (ii) early transient eczema (21.6%); (iii) late-onset eczema (LOE; 8.1%); (iv) intermittent eczema (INT; 7.5%); and (v) persistent eczema (PE; 11.8%). There was very-high agreement between the assignment of individual children into clusters when using complete or imputed (n = 15 848) data (adjusted Rand index = 0.99; i.e. the clusters were very stable). Within-individual symptom patterns across clusters confirmed within-cluster homogeneity, with consistent patterns of symptoms among participants within each cluster and no overlap between the clusters. Clusters were characterized by differences in associations with risk factors (e.g. parental eczema was associated with all clusters apart from LOE; sensitization to inhalant allergens was associated with all clusters, with the highest risk in the PE cluster). All clusters apart from LOE were associated with FLG mutations. Of note, the strongest association was for PE [relative risk ratio (RRR) 2.70, 95% confidence interval (CI) 2.24–3.26; P < 0.001] followed by INT (RRR 2.29, 95% CI 1.82–2.88; P < 0.001). Conclusions Clustering of multidimensional variables identified stable clusters with different genetic architectures. Using multidimensional variables may capture eczema development and derive stable and internally homogeneous clusters. However, deriving homogeneous symptom clusters does not necessarily mean that these are underpinned by completely unique mechanisms.

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confidence: 99%

Identification of eczema clusters and their association with filaggrin and atopic comorbidities: analysis of five birth cohorts

Haider,

Granell,

Curtin

et al. 2023

British Journal of Dermatology

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“…The advent of recent longitudinal studies employing advanced statistical methods has unveiled distinct clusters within atopic dermatitis. This development poses a challenge in accurately identifying the risk group for the subsequent development of atopic diseases [30].…”

Section: Atopic Dermatitismentioning

confidence: 99%

Atopic March or Atopic Multimorbidity—Overview of Current Research

Mrkić Kobal,

Plavec,

Vlašić Lončarić

et al. 2023

Medicina

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The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions.

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“…AD has a chronic, relapsing disease course. Indeed, patients experience repeated exacerbations and improvements during their clinical course [18,19]. The QoL of patients with AD can vary greatly depending on various factors, such as the severity of their symptoms and exposed skin areas [20][21][22][23].…”

Section: Psychological Burden Of Ad In Koreamentioning

confidence: 99%

Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Korea

Woo

Kim

2023

JCM

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Atopic dermatitis (AD) is a chronic inflammatory skin condition associated with a significant disease burden in Korea. AD is highly prevalent among Korean children, adolescents, and adults, and can cause physical discomfort, psychological distress, and social isolation for those affected. Despite advances in our understanding of AD, there are still many unmet needs in diagnosing and managing the disease in Korea. One of the challenges in diagnosing AD is the lack of a definitive biomarker for AD in Korea, and there is a need for more effective, safe, and cost-effective treatments for AD. Therefore, finding out the current epidemiology, burden of AD, and how AD is currently being diagnosed in Korea and reviewing management options available in Korea will help resolve the unmet needs of AD patients in Korea. Addressing these and other unmet needs in AD management and diagnosis in Korea may improve outcomes for those affected by this challenging condition.

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Evaluating the Longitudinal Course of Atopic Dermatitis: Implications for Clinical Practice

Cited by 14 publications

References 104 publications

Identification of eczema clusters and their association with filaggrin and atopic comorbidities: analysis of five birth cohorts

Identification of eczema clusters and their association with filaggrin and atopic comorbidities: analysis of five birth cohorts

Atopic March or Atopic Multimorbidity—Overview of Current Research

Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Korea

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