BACKGROUND: It is commonly believed that the majority of infants and young children with early atopic eczema will develop asthma in later childhood. This belief is mainly based on cross-sectional population studies. Recent evidence suggests a more complex relationship between early eczema and asthma. OBJECTIVE: This systematic review was conducted to assess the risk of developing asthma in children with atopic eczema during the first 4 years of life. METHODS: A sensitive search was performed to identify all prospective cohort studies on the topic. By pooling the eligible reports, we calculated the risk of developing asthma at 6 years of age or older in children with atopic eczema in the first 4 years of life. RESULTS: Thirteen prospective cohort studies were included, with 4 representing birth cohort studies and 9 representing eczema cohort studies. The pooled odds ratio for the risk of asthma after eczema, compared with children without eczema, in birth cohort studies was 2.14 (95% CI, 1.67-2.75). The prevalence of asthma at the age of 6 years in eczema cohort studies was 35.8% (95% CI, 32.2% to 39.9%) for inpatients and 29.5% (95% CI, 28.2% to 32.7%) for a combined group of inpatients and outpatients. CONCLUSION: Although there is an increased risk of developing asthma after eczema in early childhood, only 1 in every 3 children with eczema develops asthma during later childhood. This is lower than previously assumed. CLINICAL IMPLICATIONS: Our results may have important consequences for counseling patients with atopic eczema and their parents.
BACKGROUND: It is commonly believed that the majority of infants and young children with early atopic eczema will develop asthma in later childhood. This belief is mainly based on cross-sectional population studies. Recent evidence suggests a more complex relationship between early eczema and asthma. OBJECTIVE: This systematic review was conducted to assess the risk of developing asthma in children with atopic eczema during the first 4 years of life. METHODS: A sensitive search was performed to identify all prospective cohort studies on the topic. By pooling the eligible reports, we calculated the risk of developing asthma at 6 years of age or older in children with atopic eczema in the first 4 years of life. RESULTS: Thirteen prospective cohort studies were included, with 4 representing birth cohort studies and 9 representing eczema cohort studies. The pooled odds ratio for the risk of asthma after eczema, compared with children without eczema, in birth cohort studies was 2.14 (95% CI, 1.67-2.75). The prevalence of asthma at the age of 6 years in eczema cohort studies was 35.8% (95% CI, 32.2% to 39.9%) for inpatients and 29.5% (95% CI, 28.2% to 32.7%) for a combined group of inpatients and outpatients. CONCLUSION: Although there is an increased risk of developing asthma after eczema in early childhood, only 1 in every 3 children with eczema develops asthma during later childhood. This is lower than previously assumed. CLINICAL IMPLICATIONS: Our results may have important consequences for counseling patients with atopic eczema and their parents.
Authors: Lynda Schneider; Jon Hanifin; Mark Boguniewicz; Lawrence F Eichenfield; Jonathan M Spergel; Rada Dakovic; Amy S Paller Journal: Pediatr Dermatol Date: 2016-06-07 Impact factor: 1.588
Authors: Elisabet Johansson; Jocelyn M Biagini Myers; Lisa J Martin; Hua He; Patrick Ryan; Grace K LeMasters; David I Bernstein; James Lockey; Gurjit K Khurana Hershey Journal: Clin Exp Allergy Date: 2019-03-27 Impact factor: 5.018
Authors: Lawrence F Eichenfield; Wynnis L Tom; Sarah L Chamlin; Steven R Feldman; Jon M Hanifin; Eric L Simpson; Timothy G Berger; James N Bergman; David E Cohen; Kevin D Cooper; Kelly M Cordoro; Dawn M Davis; Alfons Krol; David J Margolis; Amy S Paller; Kathryn Schwarzenberger; Robert A Silverman; Hywel C Williams; Craig A Elmets; Julie Block; Christopher G Harrod; Wendy Smith Begolka; Robert Sidbury Journal: J Am Acad Dermatol Date: 2013-11-27 Impact factor: 11.527