Phenotypes of atopic dermatitis and the risk for subsequent asthma: A systematic review and meta-analysis

Abstract

Background: Various atopic dermatitis (AD) phenotypes showed an enormously heterogenic risk for subsequent asthma development.

Objective: We aimed to investigate the association between AD phenotypes and the risk for progression to asthma.

Methods: We searched PubMed, Embase, and Web of Science databases for relevant publications. Pooled relative risks (RR) with 95% CI were calculated using the CMA-3.0 software. This study has been registered with PROSPERO (CRD42019129273).

Results: We analyzed 39 publications with 458,810 participants. The RR for asthma in AD was 2.16 (95% CI, 1.88-2.48). The risk in persistent AD (RR, 3.36; 95% CI, 2.83-3.99) was higher than in transient AD (RR, 1.52; 95% CI, 1.34-1.73), and the risk in severe AD (RR, 2.40; 95% CI, 1.96-2.94) was higher than in mild AD (RR, 1.82; 95% CI, 1.03-3.23) or moderate AD (RR, 1.51; 95% CI, 1.30-1.75). The risk for asthma in early-onset AD was slightly higher than in late-onset AD and higher in boys than in girls.

Limitations: The AD and asthma definitions differed across the included studies.

Conclusion: Patients with persistent or severe AD were at a higher risk for developing asthma. These findings further elucidate the atopic march and identify target populations for asthma prevention.

Keywords: asthma; atopic dermatitis; meta-analysis; phenotype; risk; systematic review.