American Journal of Clinical Dermatology

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Sanofi

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Dermatol Reports.

Allergol Immunopathol (Madr)

Ann Allergy Asthma Immunol

Expert Rev Clin Immunol

J Allergy Clin Immunol

PNAS USA

Nat Rev Drug Discov

Allergy

Lancet

J Am Acad Dermatol

BMJ Open

Br J Dermatol

J Cutan Med Surg

Dermatitis

Dermatol Ther (Heidelb).

Dermatol Ther (Heidelb)

Acta Derm Venereol

JAMA Dermatol

Atopic dermatitis (AD), a chronic systemic disease, can cause intense skin itching and negatively impact sleep, mood, and quality of life (QoL) for patients and families.
PEDISTAD is an ongoing, 10-year, observational registry describing disease characteristics, atopic comorbidities, and treatment patterns in pediatric patients (aged <12 years at enrollment) with moderate-to-severe AD. This 3-year interim analysis evaluates clinician-reported and caregiver-reported/patient-reported outcomes (Eczema Area and Severity Index [EASI], percent body surface area affected, worst itching/scratching, Children's Dermatology Life Quality Index, and Dermatitis Family Impact) in children treated with dupilumab, methotrexate, and/or cyclosporine. Outcomes were assessed as change from therapy start to last observation (either data cutoff date or treatment discontinuation).
Mean (±SE) EASI scores at the time of the last 3-year interim observation were consistent with mild disease in the dupilumab cohort and moderate disease in the methotrexate and cyclosporine cohorts. Improvements in pruritus were numerically greater in the dupilumab cohort relative to the methotrexate and cyclosporine cohorts, while improvements in QoL were similar in the dupilumab and methotrexate cohorts, with no significant change in the cyclosporine cohort. Rates of AD exacerbation were numerically lower with dupilumab treatment relative to methotrexate treatment which were numerically lower than cyclosporine treatment. Dupilumab discontinuation rates were numerically lower relative to methotrexate which were numerically lower than cyclosporine.
This PEDISTAD 3-year interim analysis of dupilumab, methotrexate, and cyclosporine treatment in children with AD demonstrates numerically greater improvements in AD signs, symptoms and QoL with dupilumab treatment relative to methotrexate and cyclosporine [Video abstract and graphical abstract available].
NCT03687359. Supplementary file1 (MP4 58163 KB).
Atopic dermatitis (AD) is a chronic inflammatory skin disease, often diagnosed before 5 years of age. AD causes intense itching and negatively impacts the sleep, mood, and quality of life of affected children and their families. Children may be treated with skin creams and ointments, which are often not enough to treat all AD signs (extent and severity of disease assessed by a clinician) and symptoms (burden of disease reported by a patient and/or caregiver). The drug dupilumab is approved for use in children as young as 6 months with moderate-to-severe AD and has shown improvements in signs and symptoms in clinical trials (sponsored by Regeneron Pharmaceuticals Inc., and Sanofi). We compared the use of dupilumab, methotrexate, and cyclosporine in routine clinical practice in children under the age of 12 years with moderate-to-severe AD using 3-year data from the PEDISTAD study. Compared with children treated with methotrexate and cyclosporine, children treated with dupilumab had greater improvements in the extent and severity of their AD, as assessed by their doctor. Children treated with dupilumab also showed greater improvements in how they described the severity of their symptoms, such as daytime/nighttime itching, and their quality of life. Fewer children using dupilumab stopped treatment and fewer reported side effects compared with those using methotrexate and cyclosporine. In summary, dupilumab-treated children had greater improvements in AD signs, AD symptoms, and quality of life, were more likely to continue treatment, and had fewer reported side effects than those given cyclosporine and methotrexate.

Systemic Treatments in Moderate-to-Severe Atopic Dermatitis in Pediatric Patients up to 12 Years of Age: Real-World Treatment Outcomes from the PEDISTAD Registry.

Systemic Treatments in Moderate-to-Severe Atopic Dermatitis in Pediatric Patients up to 12 Years of Age: Real-World Treatment Outcomes from the PEDISTAD Registry

JAMA Dermatology

<jats:sec id="ab-dbr230020-4"><jats:title>Importance</jats:title><jats:p>Vitiligo is a multifactorial, depigmenting skin disorder characterized by selective loss of melanocytes. Large-scale studies are lacking to determine the risk of vitiligo in transplant recipients with graft-vs-host disease (GVHD).</jats:p></jats:sec><jats:sec id="ab-dbr230020-5"><jats:title>Objective</jats:title><jats:p>To investigate the incidence rates and risk of vitiligo in patients who had received solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) overall and by HSCT graft type and concomitant GVHD.</jats:p></jats:sec><jats:sec id="ab-dbr230020-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This population-based cohort study included data from the National Health Insurance Service database of Korea for patients aged 20 years or older who had received a transplant (SOT or HSCT) between January 2010 and December 2017, with follow-up until December 2019. A cohort of age- and sex-matched (1:5) control individuals who did not receive a transplant was included for comparison. Data were analyzed from July 2021 to December 2021.</jats:p></jats:sec><jats:sec id="ab-dbr230020-7"><jats:title>Exposure</jats:title><jats:p>Transplant (SOT or HSCT) and GVHD.</jats:p></jats:sec><jats:sec id="ab-dbr230020-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The main outcome was risk of vitiligo, assessed using multivariable Cox proportional hazards regression analyses adjusting for potential confounding factors.</jats:p></jats:sec><jats:sec id="ab-dbr230020-9"><jats:title>Results</jats:title><jats:p>The study included 23 829 patients who had undergone SOT or HSCT (62.78% male; mean [SD] age, 49.58 [11.59] years) and 119 145 age- and sex-matched controls. Patients who had undergone transplant had a significantly higher risk of vitiligo compared with controls (adjusted hazard ratio [AHR], 1.73; 95% CI, 1.35-2.22). Risk of vitiligo was also slightly higher in kidney transplant recipients and liver transplant recipients compared with the controls but was highest in HSCT recipients (AHR, 12.69; 95% CI, 5.11-31.50). Patients who had received allogeneic grafts (AHR, 14.43; 95% CI, 5.61-37.15), those who had received autologous grafts (AHR, 5.71; 95% CI, 1.20-3.18), those with comorbid GVHD (AHR, 24.09; 95% CI, 9.16-63.35), and those without GVHD (AHR, 8.21; 95% CI, 3.08-21.87) had a higher risk of vitiligo compared with controls.</jats:p></jats:sec><jats:sec id="ab-dbr230020-10"><jats:title>Conclusion and Relevance</jats:title><jats:p>In this study, risk of vitiligo was significantly higher in transplant recipients, especially in HSCT recipients and those with allogeneic grafts or comorbid GVHD. These findings provide new insights into the association between the risk of vitiligo and transplant and GVHD. Clinicians should be aware of these risks, implementing a multidisciplinary approach for monitoring.</jats:p></jats:sec>

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Vitiligo following a combined liver-kidney transplant.

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Generalized vitiligo after allogeneic bone marrow transplantation.

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PLoS One

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World J Gastroenterol

Graft-versus-host disease after solid organ transplantation: a single center experience and review of literature.

Ann Transplant

Adoptive transfer of vitiligo after allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma.

Transfer of vitiligo after allogeneic bone marrow transplantation.

Vitiligo following stem-cell transplant.

Bone Marrow Transplant

Vitiligo is a multifactorial, depigmenting skin disorder characterized by selective loss of melanocytes. Large-scale studies are lacking to determine the risk of vitiligo in transplant recipients with graft-vs-host disease (GVHD).
To investigate the incidence rates and risk of vitiligo in patients who had received solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT) overall and by HSCT graft type and concomitant GVHD.
This population-based cohort study included data from the National Health Insurance Service database of Korea for patients aged 20 years or older who had received a transplant (SOT or HSCT) between January 2010 and December 2017, with follow-up until December 2019. A cohort of age- and sex-matched (1:5) control individuals who did not receive a transplant was included for comparison. Data were analyzed from July 2021 to December 2021.
Transplant (SOT or HSCT) and GVHD.
The main outcome was risk of vitiligo, assessed using multivariable Cox proportional hazards regression analyses adjusting for potential confounding factors.
The study included 23 829 patients who had undergone SOT or HSCT (62.78% male; mean [SD] age, 49.58 [11.59] years) and 119 145 age- and sex-matched controls. Patients who had undergone transplant had a significantly higher risk of vitiligo compared with controls (adjusted hazard ratio [AHR], 1.73; 95% CI, 1.35-2.22). Risk of vitiligo was also slightly higher in kidney transplant recipients and liver transplant recipients compared with the controls but was highest in HSCT recipients (AHR, 12.69; 95% CI, 5.11-31.50). Patients who had received allogeneic grafts (AHR, 14.43; 95% CI, 5.61-37.15), those who had received autologous grafts (AHR, 5.71; 95% CI, 1.20-3.18), those with comorbid GVHD (AHR, 24.09; 95% CI, 9.16-63.35), and those without GVHD (AHR, 8.21; 95% CI, 3.08-21.87) had a higher risk of vitiligo compared with controls.
In this study, risk of vitiligo was significantly higher in transplant recipients, especially in HSCT recipients and those with allogeneic grafts or comorbid GVHD. These findings provide new insights into the association between the risk of vitiligo and transplant and GVHD. Clinicians should be aware of these risks, implementing a multidisciplinary approach for monitoring.

Risk of Subsequent Vitiligo in Transplant Recipients With Comorbid Graft-vs-Host Disease.

Risk of Subsequent Vitiligo in Transplant Recipients With Comorbid Graft-vs-Host Disease

<jats:p>This cohort study provides detailed annual rates and percentage changes of melanoma incidence before vs during the COVID-19 pandemic.</jats:p>

Delays in melanoma presentation during the COVID-19 pandemic: a nationwide multi-institutional cohort study.

Impact of COVID-19 pandemic on melanoma presentation by facility type and region in the United States.

Global association of COVID-19 pandemic measures with cancer screening: a systematic review and meta-analysis.

JAMA Oncol

The rapid rise in cutaneous melanoma diagnoses.

N Engl J Med

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JCO Clin Cancer Inform

This cohort study provides detailed annual rates and percentage changes of melanoma incidence before vs during the COVID-19 pandemic.

Incidence of In Situ and Invasive Cutaneous Melanomas During the COVID-19 Pandemic in the US.

Incidence of In Situ and Invasive Cutaneous Melanomas During the COVID-19 Pandemic in the US

<jats:sec id="ab-doi230037-4"><jats:title>Importance</jats:title><jats:p>Data on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) separately.</jats:p></jats:sec><jats:sec id="ab-doi230037-5"><jats:title>Objectives</jats:title><jats:p>To examine the risk of new-onset IBD, UC, and CD in children and adults with AD.</jats:p></jats:sec><jats:sec id="ab-doi230037-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This population-based cohort study assessed patients with AD matched with up to 5 controls on age, practice, and index date. Treatment exposure was used as a proxy for AD severity. Data were retrieved from The Health Improvement Network, a UK electronic medical record database, for January 1, 1994, to February 28, 2015. Data analysis was performed from January 8, 2020, to June 30, 2023.</jats:p></jats:sec><jats:sec id="ab-doi230037-7"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Outcomes of interest were incident IBD, UC, and CD. Logistic regression was used to examine the risk for each outcome in children and adults with AD compared with controls.</jats:p></jats:sec><jats:sec id="ab-doi230037-8"><jats:title>Results</jats:title><jats:p>A total of 1 809 029 pediatric controls were matched to 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe). The pediatric cohort ranged in median age from 4 to 5 years (overall range, 1-10 years), was predominantly male (936 750 [51.8%] controls, 196 996 [51.6%] with mild AD, 11 379 [50.7%] with moderate AD, and 2985 [56.1%] with severe AD), and with similar socioeconomic status. A total of 2 678 888 adult controls were matched to 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe). The adult cohort ranged in median age from 45 to 50 years (overall range, 30-68 years) and was predominantly female (1 445 589 [54.0%] controls, 256 071 [62.3%] with mild AD, 109 404 [55.8%] with moderate AD, and 10 736 [59.3%] with severe AD). In fully adjusted models, children with AD had a 44% increased risk of IBD (hazard ratio [HR], 1.44; 95% CI, 1.31-1.58) and a 74% increased risk of CD (HR, 1.74; 95% CI, 1.54-1.97), which increased with worsening AD; however, they did not have increased risk of UC (HR, 1.09; 95% CI, 0.94-1.27) except for those with severe AD (HR, 1.65; 95% CI, 1.02-2.67). Adults with AD had a 34% (HR, 1.34; 95% CI, 1.27-1.40) increased risk of IBD, a 36% (HR, 1.36; 95% CI, 1.26-1.47) increased risk of CB, and a 32% (HR, 1.32; 95% CI, 1.24-1.41) increased risk of UC, with risk increasing with worsening AD.</jats:p></jats:sec><jats:sec id="ab-doi230037-9"><jats:title>Conclusion and Relevance</jats:title><jats:p>In this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD. Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.</jats:p></jats:sec>

Real-world comorbidities of atopic dermatitis in the pediatric ambulatory population in the United States.

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Atopic dermatitis does not increase the risk of inflammatory bowel disease: a nationwide cohort study.

J Dermatol

Autoimmune disease comorbidities in patients with atopic dermatitis: a nationwide case-control study in Taiwan.

Pediatr Allergy Immunol

Bidirectional relationship between atopic dermatitis and inflammatory bowel disease: a systematic review and meta-analysis.

Inflammatory bowel disease is associated with an increased risk of inflammatory skin diseases: a population-based cross-sectional study.

Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001-2002.

Inflamm Bowel Dis

Autoimmune diseases in adults with atopic dermatitis.

Association between atopic dermatitis and autoimmune disorders in US adults and children: a cross-sectional study.

Occurrence of inflammatory bowel disease in patients with chronic inflammatory skin diseases: a cohort study.

Comorbidities in adolescents with inflammatory bowel disease: findings from a population-based cohort study.

Pediatr Res

New-onset inflammatory bowel disease in adults with atopic dermatitis.

J Eur Acad Dermatol Venereol

An association between ulcerative colitis and atopic dermatitis, diseases of impaired superficial barriers.

J Invest Dermatol

Approach to the management of recently diagnosed inflammatory bowel disease patients: a user’s guide for adult and pediatric gastroenterologists.

Gastroenterology

The Read clinical classification.

Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies.

J Rheumatol

Development and validation of an algorithm to accurately identify atopic eczema patients in primary care electronic health records from the UK.

Validity of psoriatic arthritis and capture of disease modifying antirheumatic drugs in the health improvement network.

Pharmacoepidemiol Drug Saf

Validation studies of the health improvement network (THIN) database for pharmacoepidemiology research.

Validity and completeness of the General Practice Research Database for studies of inflammatory bowel disease.

Risk of herpesvirus, serious and opportunistic infections in atopic dermatitis: a population-based cohort study.

Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study.

Atopic eczema in adulthood and mortality: UK population-based cohort study, 1998-2016.

Atopic eczema and obesity: a population-based study.

Association between atopic eczema and cancer in England and Denmark.

Atopic eczema and fracture risk in adults: a population-based cohort study.

Atopic eczema in adulthood and risk of depression and anxiety: a population-based cohort study.

J Allergy Clin Immunol Pract

Model building strategy for logistic regression: purposeful selection.

Ann Transl Med

Sensitivity analysis in observational research: introducing the E-value.

Ann Intern Med

Atopic dermatitis is associated with an increased risk for rheumatoid arthritis and inflammatory bowel disease, and a decreased risk for type 1 diabetes.

Atopic diseases are associated with development of inflammatory bowel diseases in Korea: a nationwide population-based study.

Clin Gastroenterol Hepatol

The bidirectional association between inflammatory bowel disease and atopic dermatitis: a systematic review and meta-analysis.

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Semin Immunopathol

Immunological decision-making: how does the immune system decide to mount a helper T-cell response?

Immunology

IL-25 (IL-17E) in epithelial immunology and pathophysiology.

Roles of IL-25 in type 2 inflammation and autoimmune pathogenesis.

Front Immunol

IL-25 regulates Th17 function in autoimmune inflammation.

J Exp Med

Interleukin-25 inhibits interleukin-12 production and Th1 cell-driven inflammation in the gut.

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Semin Pediatr Surg

Specificities of inflammatory bowel disease in childhood.

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Diagnostic considerations in pediatric inflammatory bowel disease management.

Gastroenterol Hepatol (N Y)

NOD2 and inflammation: current insights.

J Inflamm Res

Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn’s disease.

Nature

A frameshift mutation in NOD2 associated with susceptibility to Crohn’s disease.

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Molecules

NOD2 and TLR2 ligands trigger the activation of basophils and eosinophils by interacting with dermal fibroblasts in atopic dermatitis-like skin inflammation.

Cell Mol Immunol

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Atopic eczema and major cardiovascular outcomes: a systematic review and meta-analysis of population-based studies.

Changing patterns in the epidemiology and outcomes of inflammatory bowel disease in the United Kingdom: 2000-2018.

Aliment Pharmacol Ther

Data on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) separately.
To examine the risk of new-onset IBD, UC, and CD in children and adults with AD.
This population-based cohort study assessed patients with AD matched with up to 5 controls on age, practice, and index date. Treatment exposure was used as a proxy for AD severity. Data were retrieved from The Health Improvement Network, a UK electronic medical record database, for January 1, 1994, to February 28, 2015. Data analysis was performed from January 8, 2020, to June 30, 2023.
Outcomes of interest were incident IBD, UC, and CD. Logistic regression was used to examine the risk for each outcome in children and adults with AD compared with controls.
A total of 1 809 029 pediatric controls were matched to 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe). The pediatric cohort ranged in median age from 4 to 5 years (overall range, 1-10 years), was predominantly male (936 750 [51.8%] controls, 196 996 [51.6%] with mild AD, 11 379 [50.7%] with moderate AD, and 2985 [56.1%] with severe AD), and with similar socioeconomic status. A total of 2 678 888 adult controls were matched to 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe). The adult cohort ranged in median age from 45 to 50 years (overall range, 30-68 years) and was predominantly female (1 445 589 [54.0%] controls, 256 071 [62.3%] with mild AD, 109 404 [55.8%] with moderate AD, and 10 736 [59.3%] with severe AD). In fully adjusted models, children with AD had a 44% increased risk of IBD (hazard ratio [HR], 1.44; 95% CI, 1.31-1.58) and a 74% increased risk of CD (HR, 1.74; 95% CI, 1.54-1.97), which increased with worsening AD; however, they did not have increased risk of UC (HR, 1.09; 95% CI, 0.94-1.27) except for those with severe AD (HR, 1.65; 95% CI, 1.02-2.67). Adults with AD had a 34% (HR, 1.34; 95% CI, 1.27-1.40) increased risk of IBD, a 36% (HR, 1.36; 95% CI, 1.26-1.47) increased risk of CB, and a 32% (HR, 1.32; 95% CI, 1.24-1.41) increased risk of UC, with risk increasing with worsening AD.
In this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD. Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.

Risk of Inflammatory Bowel Disease in Patients With Atopic Dermatitis.

Risk of Inflammatory Bowel Disease in Patients With Atopic Dermatitis

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