1
|
Puerta Durango K, Chiesa Fuxench ZC. Global Burden of Atopic Dermatitis: Examining Disease Prevalence Across Pediatric and Adult Populations World-Wide. Dermatol Clin 2024; 42:519-525. [PMID: 39278705 DOI: 10.1016/j.det.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
Atopic Dermatitis (AD) is a common, pruritic inflammatory skin disease associated with marked disease burden and substantial health care costs. AD does not discriminate between populations; prevalence estimates vary widely with most studies focusing on general or pediatric populations and a limited number of studies in adult populations solely. The costs of treating AD are staggering. Studies that examine differences in prevalence may be difficult to compare due to differences in study designs. However, understanding the prevalence of AD across populations is critical if we are to improve the lives of patients and caregivers living with this disease.
Collapse
Affiliation(s)
- Kevin Puerta Durango
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 7th Floor South Tower, Philadelphia, PA 19104, USA
| | - Zelma C Chiesa Fuxench
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 7th Floor South Tower, Philadelphia, PA 19104, USA.
| |
Collapse
|
2
|
Faye O, Flohr C, Kabashima K, Ma L, Paller AS, Rapelanoro FR, Steinhoff M, Su JC, Takaoka R, Wollenberg A, Yew YW, Postigo JAR, Schmid-Grendelmeier P, Taïeb A. Atopic dermatitis: A global health perspective. J Eur Acad Dermatol Venereol 2024; 38:801-811. [PMID: 38151270 DOI: 10.1111/jdv.19723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
The International Society of AD (ISAD) organized a roundtable on global aspects of AD at the WCD 2023 in Singapore. According to the Global Burden of Disease (GBD) consortium, at least 171 million individuals were affected with AD in 2019, corresponding to 2.23% of the world population, with age-standardized prevalence and incidence rates that were relatively stable from 1990 to 2019. Based on the panel experience, most AD cases are mild-to-moderate. Without parallel data on disease prevalence and severity, the GBD data are difficult to interpret in many regions. This gap is particularly important in countries with limited medical infrastructure, but indirect evidence suggests a significant burden of AD in low-and-medium resource settings, especially urban areas. The Singapore roundtable was an opportunity to compare experiences in World Bank category 1 (Madagascar and Mali), 3 (Brazil, China) and 4 (Australia, Germany, Qatar, USA, Singapore, Japan) countries. The panel concluded that current AD guidelines are not adapted for low resource settings and a more pragmatic approach, as developed by WHO for skin NTDs, would be advisable for minimal access to moisturizers and topical corticosteroids. The panel also recommended prioritizing prevention studies, regardless of the level of existing resources. For disease long-term control in World Bank category 3 and most category 4 countries, the main problem is not access to drugs for most mild-to-moderate cases, but rather poor compliance due to insufficient time at visits. Collaboration with WHO, patient advocacy groups and industry may promote global change, improve capacity training and fight current inequalities. Finally, optimizing management of AD and its comorbidities needs more action at the primary care level, because reaching specialist care is merely aspirational in most settings. Primary care empowerment with store and forward telemedicine and algorithms based on augmented intelligence is a future goal.
Collapse
Affiliation(s)
- Ousmane Faye
- Department of Dermatology, Faculty of Medicine and Odontostomatology, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Carsten Flohr
- Paediatric & Population-Based Dermatology Research, St John's Institute of Dermatology, London, UK
- Guy & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Singapore Research Institute of Singapore (SRIS), Kyoto, Japan
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology, and Research (A*STAR)Biopolis, Singapore City, Singapore
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- School of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York City, New York, USA
| | - John C Su
- Eastern Health, Monash University, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Takaoka
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andreas Wollenberg
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
- University Hospital Augsburg, Augsburg, Germany
- Ludwig-Maximilian University, Munich, Germany
| | | | | | - Peter Schmid-Grendelmeier
- International Society of Atopic Dermatitis, Davos, Switzerland
- World Allergy Organization, Milwaukee, Wisconsin, USA
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - Alain Taïeb
- International Society of Atopic Dermatitis, Davos, Switzerland
- INSERM U 1312, University of Bordeaux, Bordeaux, France
| |
Collapse
|
3
|
Schaffer AL, Bruno C, Buckley NA, Cairns R, Litchfield M, Paget S, Zoega H, Nassar N, Pearson S. Prescribed medicine use and extent of off-label use according to age in a nationwide sample of Australian children. Paediatr Perinat Epidemiol 2022; 36:726-737. [PMID: 35172017 PMCID: PMC9540111 DOI: 10.1111/ppe.12870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/16/2022] [Accepted: 01/25/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Medicine prescribing for children is impacted by a lack of paediatric-specific dosing, efficacy and safety data for many medicines. OBJECTIVES To estimate the prevalence of medicine use among children and the rate of 'off-label' prescribing according to age at dispensing. METHODS We used population-wide primarily outpatient dispensing claims data for 15% of Australian children (0-17 years), 2013-2017 (n = 840,190). We estimated prescribed medicine use and 'off-label' medicine use according to the child's age (<1 year, 1-5 years, 6-11 years, 12-17 years) defined as medicines without age-appropriate dose recommendations in regulator-approved product information. Within off-label medicines, we also identified medicines with and without age-specific dose recommendations in a national prescribing guide, the Australian Medicines Handbook Children's Dosing Companion (AMH CDC). RESULTS The overall dispensing rate was 2.0 dispensings per child per year. The medicines with the highest average yearly prevalence were systemic antibiotics (435.3 per 1000 children), greatest in children 1-5 years (546.9 per 1000). Other common medicine classes were systemic corticosteroids (92.7 per 1000), respiratory medicines (91.2 per 1000), acid-suppressing medicines in children <1 year (47.2 per 1000), antidepressants in children 12-17 years (40.3 per 1000) and psychostimulants in children 6-11 years (27.0 per 1000). We identified 12.2% of dispensings as off-label based on age, but 66.3% of these had age-specific dosing recommendations in the AMH CDC. Among children <1 year, off-label dispensings were commonly acid-suppressing medicines (35.5%) and topical hydrocortisone (33.1%); in children 6-11 years, off-label prescribing of clonidine (16.0%) and risperidone (13.1%) was common. Off-label dispensings were more likely to be prescribed by a specialist (21.7%) than on-label dispensings (7.5%). CONCLUSIONS Prescribed medicine use is common in children, with off-label dispensings for medicines without paediatric-specific dosing guidelines concentrated in classes such as acid-suppressing medicines and psychotropics. Our findings highlight a need for better evidence to support best-practice prescribing.
Collapse
Affiliation(s)
- Andrea L. Schaffer
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | - Claudia Bruno
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | - Nicholas A. Buckley
- Biomedical Informatics and Digital HealthThe University of SydneySydneyNew South WalesAustralia,NSW Poisons Information CentreThe Children’s Hospital at WestmeadSydneyNew South WalesAustralia
| | - Rose Cairns
- NSW Poisons Information CentreThe Children’s Hospital at WestmeadSydneyNew South WalesAustralia,Faculty of PharmacyThe University of SydneySydneyNew South WalesAustralia
| | - Melisa Litchfield
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | - Simon Paget
- The Children’s Hospital at Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Helga Zoega
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia,Centre of Public Health SciencesFaculty of MedicineUniversity of IcelandReykjavikIceland
| | - Natasha Nassar
- The Children’s Hospital at Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia,Menzies Centre for Health PolicyThe University of SydneySydneyNew South WalesAustralia
| | - Sallie‐Anne Pearson
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia,Menzies Centre for Health PolicyThe University of SydneySydneyNew South WalesAustralia
| |
Collapse
|
4
|
Churnosov M, Belyaeva T, Reshetnikov E, Dvornyk V, Ponomarenko I. Polymorphisms of the filaggrin gene are associated with atopic dermatitis in the Caucasian population of Central Russia. Gene 2022; 818:146219. [PMID: 35092857 DOI: 10.1016/j.gene.2022.146219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 11/16/2022]
Abstract
Association of the filaggrin (FLG) gene with atopic dermatitis (AD) in Caucasians from Central Russia was studied in the sample of 700 patients and 612 controls. In total ten SNPs of the gene (rs61816761, rs12130219, rs77199844, rs558269137, rs4363385, rs12144049, rs471144, rs6661961, rs10888499, rs3126085), their haplotypes and interlocus interactions were analyzed using logistic regression. The functional effects of the AD risk candidate loci and their proxies (136 SNPs) were evaluated by in silico analysis. All analyzed SNPs were associated with AD: two SNPs (rs3126085 and rs12144049) manifested the independent association, nine SNPs were associated within 30 haplotypes, and seven SNPs showed interlocus interaction effects within ten most significant epistatic models. Alleles A rs3126085 and C rs12144049 were associated with a higher risk of AD according to the allelic (ORs being 1.75, pperm = 0.002 and 1.45, pperm = 0.011 respectively), additive (ORs being 1.69, pperm = 0.004 and 1.47, pperm = 0.011 respectively) and dominant (ORs being 1.79, pperm = 0.004 and 1.63, pperm = 0.005 respectively) genetic models. Three haplotypes, GT[rs3126085-rs12144049] (OR = 0.60), GGT[rs61816761-rs3126085-rs12144049] (OR = 0.59), and AWGGT[rs12130219-rs558269137-rs61816761-rs3126085-rs12144049] (OR = 0.63) demonstrated the protective effect (pperm = 0.001). The in silico analysis suggested that the AD risk variants and their proxies apparently produce various effects on 38 genes in various tissue/organs (including 20 genes in the skin). The biological process enrichment analyses suggest that the target AD candidate genes influence the formation of the cornified envelope, keratinization and cornification, and more than twenty other pathways related to skin development, programmed cell death, and regulation of water loss via skin.
Collapse
Affiliation(s)
- Mikhail Churnosov
- Department of Medical Biological Disciplines, Belgorod State University, 308015 Belgorod, Russia.
| | - Tatyana Belyaeva
- Department of Medical Biological Disciplines, Belgorod State University, 308015 Belgorod, Russia
| | - Evgeny Reshetnikov
- Department of Medical Biological Disciplines, Belgorod State University, 308015 Belgorod, Russia
| | - Volodymyr Dvornyk
- Department of Life Sciences, College of Science and General Studies, Alfaisal University, 11533 Riyadh, Saudi Arabia
| | - Irina Ponomarenko
- Department of Medical Biological Disciplines, Belgorod State University, 308015 Belgorod, Russia
| |
Collapse
|
5
|
Möhrenschlager M, Seeli C, Anasiewicz N. Atopic dermatitis in a population-based cohort from Stockholm, Sweden 24 years after start: new data, new questions. J Eur Acad Dermatol Venereol 2022; 36:634. [PMID: 35416366 DOI: 10.1111/jdv.18085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M Möhrenschlager
- Department of Dermatology, Hochgebirgsklinik, Davos, Switzerland
| | - C Seeli
- Department of Dermatology, Hochgebirgsklinik, Davos, Switzerland
| | - N Anasiewicz
- Department of Dermatology, Hochgebirgsklinik, Davos, Switzerland.,Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| |
Collapse
|
6
|
Dvornyk V, Ponomarenko I, Belyaeva T, Reshetnikov E, Churnosov M. Filaggrin gene polymorphisms are associated with atopic dermatitis in women but not in men in the Caucasian population of Central Russia. PLoS One 2021; 16:e0261026. [PMID: 34882715 PMCID: PMC8659355 DOI: 10.1371/journal.pone.0261026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background and purpose This study aimed to analyze the gender-specific association of the filaggrin (FLG) gene polymorphisms with atopic dermatitis (AD) in Caucasians from the central region of Russia. Methods The study sample consisted of 906 female (including 474 patients with AD and 432 controls) and 406 male (such as 226 patients with AD and 180 controls) participants. Genotyping of ten polymorphisms of the FLG gene was done. The logistic regression was used to analyze the associations. A total of 125 SNPs (seven AD-associated SNPs and 118 proxy SNPs, r2≥0.8) FLG gene were used for the in silico functional annotation analysis in the females. Results Significant associations were identified between seven SNPs of the FLG gene (rs12130219, rs61816761, rs558269137, rs12144049, rs3126085, rs471144, rs6661961) and AD in females: rs12144049 was associated independent individually (for allele C OR = 1.71, 95%Сl 1.19–2.46, рperm = 0.004 and OR = 1.76, 95%Сl 1.18–2.63, рperm = 0.006 according to the additive and dominant genetic models, respectively) and seven SNPs of the FLG gene within 14 haplotypes. Haplotype GGT [rs61816761-rs3126085-rs12144049] showed the strongest association (OR = 0.55, рperm = 0.001). No association between the analyzed SNPs and AD was determined in the male group. The subsequent bioinformatic analysis predicted the SNPs of the FLG gene that possessed epigenetic and non-synonymous effects, were involved in the control of gene expression and alternative splicing of genes that contribute to AD pathophysiology. Conclusion Polymorphisms of the FLG gene are associated with AD in females but not in males in the Caucasian population of Central Russia.
Collapse
Affiliation(s)
- Volodymyr Dvornyk
- Department of Life Sciences, College of Science and General Studies, Alfaisal University, Riyadh, Saudi Arabia
| | - Irina Ponomarenko
- Department of Medical Biological Disciplines, Belgorod State University, Belgorod, Russia
| | - Tatyana Belyaeva
- Department of Medical Biological Disciplines, Belgorod State University, Belgorod, Russia
| | - Evgeny Reshetnikov
- Department of Medical Biological Disciplines, Belgorod State University, Belgorod, Russia
- * E-mail:
| | - Mikhail Churnosov
- Department of Medical Biological Disciplines, Belgorod State University, Belgorod, Russia
| |
Collapse
|
7
|
Angles MV, Antonietti CA, Torre AC, Juszkiewicz Franzé E, Mazzuoccolo LD, Parisi CAS. Prevalence of atopic dermatitis in adults. An Bras Dermatol 2021; 97:107-109. [PMID: 34839985 PMCID: PMC8799860 DOI: 10.1016/j.abd.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Maria Valeria Angles
- Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | | | - Ana Clara Torre
- Department of Dermatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | | |
Collapse
|
8
|
Willems A, Tapley A, Fielding A, Tng ETV, Holliday EG, van Driel ML, Ball JI, Davey AR, Patsan I, FitzGerald K, Spike NA, Magin PJ. Prevalence and Associations of General Practice Registrars' Management of Atopic Dermatitis: A Cross-Sectional Analysis from the Registrar Clinical Encounters in Training Study. Dermatol Pract Concept 2021; 11:e2021128. [PMID: 34631271 DOI: 10.5826/dpc.1104a128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction Atopic dermatitis (AD) is a chronic inflammatory condition which imposes substantial burden upon patients and their families. As a frequent primary care presentation, general practice (GP) trainees must develop adequate skills in AD diagnosis and management. Objectives We aimed to explore the prevalence and associations of GP registrars' management of patients with AD. Methods This study used data from the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing cohort study of the clinical and educational experience of Australian GP registrars. Registrar, patient, and consultation factors were independent variables in multivariable logistic regression with outcome factor 'diagnosis/problem being AD'. Results From 2010-2019, 2,783 registrars (96% response rate) provided data from 381,180 consultations. AD was encountered in 0.6% of consults. AD was more likely to be seen in patients aged 0-1 years and patients from a non-English speaking background. AD was less likely to be seen in Aboriginal or Torres Strait Islander patients. Learning goals were more likely to be generated for AD and these consultations were associated with registrars seeking information or assistance. AD was strongly associated with a medication being prescribed, of which the most prescribed medications were mild or moderate potency topical corticosteroids. Conclusions Our findings suggest that, similar to other dermatological presentations, registrars find AD challenging to manage. There may be some gaps in AD management knowledge and application.
Collapse
Affiliation(s)
- Anneliese Willems
- Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Victoria, Australia.,University of Melbourne, Department of General Practice and Primary Health Care, Berkeley Street, Carlton, Victoria, Australia
| | - Amanda Tapley
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 Mclntosh Drive, Mayfield West, NSW, Australia
| | - Alison Fielding
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 Mclntosh Drive, Mayfield West, NSW, Australia
| | - Er Tsing Vivian Tng
- Department of Dermatology, John Hunter Hospital, Newcastle, New Lambton Heights, NSW, Australia
| | - Elizabeth G Holliday
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia
| | - Mieke L van Driel
- The University of Queensland Faculty of Medicine, Primary Care Clinical Unit, Faculty of Medicine, Level 8 Health Sciences Building, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
| | - Jean I Ball
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton, NSW, Australia
| | - Andrew R Davey
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 Mclntosh Drive, Mayfield West, NSW, Australia
| | - Irena Patsan
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 Mclntosh Drive, Mayfield West, NSW, Australia
| | - Kristen FitzGerald
- University of Tasmania Tasmanian School of Medicine, Hobart, TAS, Australia.,General Practice Training Tasmania, Regional Training Organisation, Hobart, TAS, Australia
| | - Neil A Spike
- Eastern Victoria General Practice Training, Regional Training Organisation, Hawthorn, Victoria, Australia.,University of Melbourne, Department of General Practice and Primary Health Care, Berkeley Street, Carlton, Victoria, Australia
| | - Parker J Magin
- University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, Newcastle, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, 20 Mclntosh Drive, Mayfield West, NSW, Australia
| |
Collapse
|