J. P. Thyssen, MD, PhD

Prevalences of food allergy (FA) and sensitivity (FS) were found to rise alongside atopic dermatitis (AD) severity, according to recent findings.¹

The study was conducted by its investigators to assess both the bidirectional associations and prevalence of FA, FS, and challenge-proven food allergy (CPFA).

The team further set out to determine the effects of AD severity on FA, due to their frequent co-occurrence and type 2 inflammation.

The study was authored by J. P. Thyssen, MD, PhD, from Copenhagen University Hospital’s Department of Dermatology in Bispebjerg and Frederiksberg.

“The aim of this comprehensive systematic review and meta-analysis was to determine the prevalence and bidirectional associations of AD with food sensitivity (FS), FA and challenge-proven food allergy (CPFA),” Thyssen and colleagues wrote. We searched PubMed and EMBASE and three independent reviewers performed title/abstract and full-text review and data extraction.”

Background

The investigators’ analysis began with searches of PubMed and EMBASE, with 3 independent reviewers extracting the necessary data.

Their searches assessed prevalence of FA, FS, and/or CPFA in AD patients and the reverse.

They also assessed AD associations with the 3 conditions and compared them to reference individuals without AD or the other conditions.

The team specifically used allergies to milk, peanuts, eggs, wheat, and soy for their quantitative analyses as they were the most commonly-tested.

The investigators were able to reconstruct primary information in research which lacked primary epidemiologic data, through the use of sample size data, binary data, and confidence intervals (CIs).

Findings

The research team used a total of 557 articles in their analysis, which had a sample size of 225,568 patients with AD and 1,128,322 reference individuals.

They also had a sample size of 1,357,793 patients with FA, FS, or CPFA in their analysis, and a total of 1,244,596 reference individuals.

The investigators reported that there was a 48.4% pooled prevalence of FS in patients with AD (95% confidence interval (CI): 43.7 - 53.2), a prevalence of 32.7% for FA (28.8 - 36.6), and a prevalence of 40.7% for CPFA (34.1 - 47.5).

They found that for the patients assessed there was a prevalence of AD in 45.3% of those with FA (41.4 - 49.3), 51.2% in those with FS (46.3 - 56.2), and 54.9% in those with CPFA (47.0 - 62.8).

Overall, the investigators noted that FS and FA prevalence increased alongside AD, numerically.

“Prevalences of FS and FA numerically increased with AD severity,” they wrote. “FS, FA and CPFA are common comorbidities of AD and are closely related. Physicians should be attentive to this relationship to optimize management and treatment strategies in patients.”

References:

1. Thyssen, J.P., et al. (2023), Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge-proven food allergy: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.18919.