Association Between Atopic Dermatitis and Inflammatory Bowel Disease Risk

A recent study published in JAMA Dermatology has unveiled a potentially critical link between atopic dermatitis (AD) and inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn disease (CD).

The study aimed to examine the risk of new-onset IBD, UC, and CD in children and adults with AD. This comprehensive population-based cohort study used data from The Health Improvement Network, a UK electronic medical record database, and encompassed both pediatric and adult populations.

In the pediatric cohort, consisting of 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe) and 1 809 029 controls, the findings were striking. Children with AD had a 44% increased risk of IBD, with an even higher 74% increased risk of CD. However, they did not exhibit an increased risk of UC, except for those with severe AD.

In the adult cohort, including 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe) and 2 678 888 controls, the trend continued. Adults with AD had a 34% increased risk of IBD, a 36% increased risk of CD, and a 32% increased risk of UC. Again, the risk escalated with worsening AD.

“In this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD,” concluded the study authors. “Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.”

Reference
Chiesa Fuxench ZC, Wan J, Wang S, et al. Risk of inflammatory bowel disease in patients with atopic dermatitis. JAMA Dermatol. 2023;e232875. doi:10.1001/jamadermatol.2023.2875