Risk of systemic infections in adults with atopic dermatitis: A nationwide cohort study

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Background: Atopic dermatitis (AD) has been linked to systemic infections in adulthood, but large-scale studies are few, and potential associations are unclear. Objective: To examine whether adults with AD have increased risk of developing systemic infections leading to hospital-based management. Methods: Nationwide register-based cohort study including all Danish adults from 1995 through 2017. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated by using Cox models. Results: A total of 10,602 adults with AD (median age, 29.8 y; interquartile range, 22.6-44.8) and 106,020 reference individuals were included. The overall incidence rate per 10,000 person-years of systemic infections was 180.6 (95% CI, 172.6-189.0) among adults with AD compared with 120.4 (95% CI, 118.3-122.5) among reference adults. The association between AD and systemic infections was observed for musculoskeletal (adjusted HR [aHR], 1.81; 95% CI, 1.42-2.31), heart (aHR, 1.75; 95% CI, 1.21-2.53), and upper (aHR, 1.42; 95% CI, 1.15-1.73) and lower respiratory tract infections (aHR, 1.21; 95% CI, 1.10-1.33). The risk of sepsis (aHR, 1.19; 95% CI, 1.01-1.44) and skin infections (aHR, 2.30; 95% CI, 2.01-2.62) was also increased. Limitations: The findings cannot be generalized to adults with milder AD seen outside the hospital system. Conclusion: We found an increased risk of systemic infections among adults with hospital managed AD.

OriginalsprogEngelsk
TidsskriftJournal of the American Academy of Dermatology
Vol/bind84
Udgave nummer2
Sider (fra-til)290-299
Antal sider10
ISSN0190-9622
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
Funding sources: Supported by a research grant from the French Society of Dermatology.Disclosure: Catherine Droitcourt has received honoraria from Sanofi-Genzyme. Ida Vittrup has received salary from a research grant from Regeneron Pharmaceuticals. Alexander Egeberg has received research funding from Pfizer, Eli Lilly, the Danish National Psoriasis Foundation, and the Kgl Hofbundtmager Aage Bang Foundation and honoraria as consultant and/or speaker from AbbVie, Almirall, Leo Pharma, Samsung Bioepis Co, Ltd, Pfizer, Eli Lilly and Company, Novartis, Galderma, Dermavant, Bristol Myers Squibb, Mylan, UCB, and Janssen Pharmaceuticals. Jacob Thyssen has attended advisory boards for Sanofi-Genzyme, Regeneron, LEO Pharma, Union Therapeutics, Pfizer, AbbVie, and Eli Lilly & Co; has received speaker honoraria from LEO Pharma, Regeneron, AbbVie, and Sanofi-Genzyme; and been an investigator for Sanofi-Genzyme, Eli Lilly & Co, LEO Pharma, Pfizer, and AbbVie. Author Kerbrat has no conflicts of interest to declare.

Funding Information:
Disclosure: Catherine Droitcourt has received honoraria from Sanofi-Genzyme. Ida Vittrup has received salary from a research grant from Regeneron Pharmaceuticals . Alexander Egeberg has received research funding from Pfizer , Eli Lilly , the Danish National Psoriasis Foundation , and the Kgl Hofbundtmager Aage Bang Foundation and honoraria as consultant and/or speaker from AbbVie , Almirall , Leo Pharma , Samsung Bioepis Co, Ltd , Pfizer , Eli Lilly and Company , Novartis , Galderma , Dermavant , Bristol Myers Squibb , Mylan , UCB , and Janssen Pharmaceuticals . Jacob Thyssen has attended advisory boards for Sanofi-Genzyme, Regeneron, LEO Pharma, Union Therapeutics, Pfizer, AbbVie, and Eli Lilly & Co; has received speaker honoraria from LEO Pharma, Regeneron, AbbVie, and Sanofi-Genzyme; and been an investigator for Sanofi-Genzyme, Eli Lilly & Co, LEO Pharma, Pfizer, and AbbVie. Author Kerbrat has no conflicts of interest to declare.

Funding Information:
Funding sources: Supported by a research grant from the French Society of Dermatology .

Publisher Copyright:
© 2020 American Academy of Dermatology, Inc.

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