Atopic dermatitis is associated with the clinical course of inflammatory bowel disease

Abstract

Objectives

There are a few studies about the relationship between inflammatory bowel disease (IBD) and atopic dermatitis (AD). It is implied that both diseases have common pathophysiologic mechanisms and can affect each other. However, little information is available on the effect of AD on the clinical course of patients with IBD.

Methods

This is a multi-center, retrospective, observational study. We define AD as a chronic eczematoid dermatosis diagnosed by dermatologists. Patients with concurrent IBD and AD were defined as a case group. Age, gender, and IBD subtype-matched patients without AD were included as a reference group.

Results

The numbers of patients in the case and reference groups were 61 and 122 respectively. There was a significantly shorter biologics-free survival in the case group than that in the reference group according to the multivariable-adjusted Cox regression analysis with the onset age, disease duration, smoking status, use of steroid, use of immunomodulator, initial C-reactive protein, initial erythrocyte sedimentation rate, presence of other allergic diseases and initial disease severity [hazard ratio (HR) 1.828, 95% confidence interval (CI) 1.022–3.271, p = .042]. The trend was consistent in the subgroup analysis with ulcerative colitis (HR 3.498, 95% CI 1.066–11.481, p = .039), but not with Crohn’s disease (HR 1.542, 95% CI 0.720–3.301, p = .265).

Conclusions

AD showed a significant effect on the biologics-free survival of patients with IBD and especially the UC subtype. Further mechanistic research is required to elucidate the pathogenesis of AD on the clinical course of IBD.

Keywords:

• Inflammatory bowel disease
• atopic dermatitis
• clinical course
• biologics

Ethics approval

This study protocol was approved by the Institutional Review Board of the 3 medical centers (IRB number: H-2107-176-1236 at SNUH, 10-2021-116 at SMG-SNU Boramae Medical Center, B-2202-741-407 at SNUBH) and was conducted complying with the tenets of the Declaration of Helsinki. Informed consent was waived by the board.

Author contributions

Conceptualization: Kwang Woo Kim, Seong-Joon Koh, Hyoun Woo Kang, Hyunsun Park, Hyeonjin Ha, Jin Park, Kyunghoon Kim, Yukyung Jun, Yoo Min Han, Hyun Jung Lee, Hyuk Yoon, Jong Pil Im, Young Soo Park, Ji Won Kim, Joo Sung Kim; Data collection: Kwang Woo Kim, Hyeonjin Ha, Jin Park, Kyunghoon Kim, Yukyung Jun; Data analysis: Kwang Woo Kim, Hyoun Woo Kang, Hyunsun Park, Yoo Min Han, Hyun Jung Lee, Hyuk Yoon, Jong Pil Im, Young Soo Park, Ji Won Kim, Joo Sung Kim; Supervision: Kwang Woo Kim, Seong-Joon Koh, Hyoun Woo Kang, Hyunsun Park; Writing-original draft: Kwang Woo Kim, Seong-Joon Koh; Writing-review and editing: Hyoun Woo Kang, Hyunsun Park; All authors approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) [NRF-2019R1C1C1002243, NRF-2022R1A2C200911311, NRF-2022R1F1A1076019, NRF-2021R1F1A1062000, and NRF-2020R1C1C1006264] and the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education [NRF-2016R1D1A1B03931961 and NRF-2020R1A1F10666419]. This work was also supported by the Seoul National University Hospital Research Foundation [No. 03-2022-0410 and 3020160160] and a general clinical research grant-in-aid from the Seoul Metropolitan Government Seoul National University (SMG-SNU) Boramae Medical Center [04-2023-0012].