Recent insights into comorbidities in atopic dermatitis

ABSTRACT

Introduction

The relationship between atopic dermatitis and atopic diseases such as food allergies, asthma, and allergic rhinitis in terms of co-occurrence, underlying mechanisms, and therapy is well documented. There is increasing evidence that atopic dermatitis is associated with non-atopic comorbidities such as cardiac, autoimmune, and neuropsychological comorbidities, as well as cutaneous and extracutaneous infections, establishing atopic dermatitis as a systemic disease.

Areas covered

The authors reviewed evidence on atopic and non-atopic comorbidities of atopic dermatitis. A literature search was conducted in PubMed for peer-reviewed articles published until October 2022.

Expert opinion

Atopic and non-atopic diseases coexist with atopic dermatitis more often than would be expected by chance. The effect of biologics and small molecules on atopic and non-atopic comorbidities may contribute to a better understanding of the relationship between atopic dermatitis and its comorbidities. Their relationship needs to be explored further to dismantle the underlying mechanism and move toward an atopic dermatitis endotype-based therapeutic approach.

KEYWORDS:

• Atopic dermatitis
• autoimmune
• cardio-metabolic
• comorbidities
• cutaneous
• eczema
• extracutaneous
• infections
• neuropsychological
• non-atopic

Article highlights

• Atopic and non-atopic diseases coexist with atopic dermatitis more often than would be expected by chance.

• Epidemiological findings and fundamental research provide evidence for an association between atopic dermatitis and atopic and non-atopic comorbidities.

• Currently atopic dermatitis is treated with a one-size-fits-all approach disregarding the different endotypes of atopic dermatitis and associated atopic and non-atopic comorbidities.

• Instead, it is time to develop a personalised therapeutic approach and move towards an understanding of the underlying mechanisms of such heterogeneity in endotypes of atopic dermatitis and associated atopic and non-atopic comorbidities.

• Biologics of different targets, Janus kinase inhibitors and other small molecules will aid in reforming the current, traditional treatment approach towards an endotype-targeted therapy approach of atopic dermatitis.

Acknowledgments

The authors thank the Scientific Communication Team of the IVDP, in particular Sara Tiedemann and Mario Gehoff, for copy editing.

Declaration of interest

M Augustin has served as a consultant, lecturer, researcher, and/or has received research grants from AbbVie, Almirall, Beiersdorf, Eli Lilly, Galderma, LEO, Pfizer and Sanofi-Genzyme. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One peer reviewer declares: advisory boards for Abbvie, Amgen, BMS, Boehringer Mannheim, Celgene, Janssen Cilag, Leo, Lilly, Pfizer, MSD, Novartis, Sanofi, UCB; speaker boards for Abbvie, Amgen, Boehringer Mannheim, Celgene, Janssen Cilag, Leo, Novartis, Pfizer; clinical studies for Abbvie, Amgen, Boehringer Mannheim, Celgene, Galderma, GSK, Janssen Cilag, Leo, Novartis, Pfizer, Regeneron, Sanofi. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Article highlights

• Atopic and non-atopic diseases coexist with atopic dermatitis more often than would be expected by chance.

• Epidemiological findings and fundamental research provide evidence for an association between atopic dermatitis and atopic and non-atopic comorbidities.

• Currently atopic dermatitis is treated with a one-size-fits-all approach disregarding the different endotypes of atopic dermatitis and associated atopic and non-atopic comorbidities.

• Instead, it is time to develop a personalised therapeutic approach and move towards an understanding of the underlying mechanisms of such heterogeneity in endotypes of atopic dermatitis and associated atopic and non-atopic comorbidities.

• Biologics of different targets, Janus kinase inhibitors and other small molecules will aid in reforming the current, traditional treatment approach towards an endotype-targeted therapy approach of atopic dermatitis.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.