Association of atopic dermatitis and headache disorder: a systematic review and meta-analyses.
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ABSTRACT: Background
Growing evidence suggests that headache disorders and atopic dermatitis share similar pathological mechanisms and risk factors. The aim of this study was to assess the risk for headache disorders in patients with atopic dermatitis.Methods
We systematically searched the PubMed and Embase databases from inception to December 1, 2023, for observational studies that examined risk of migraine in subjects with atopic dermatitis. Risk estimates from individual studies were pooled using random-effects models.Results
Ten studies with 12,717,747 subjects were included in the meta-analysis. Our results showed that patients with atopic dermatitis were associated with a higher risk of headache disorder (OR, 1.46, 95% CI = 1.36-1.56; P < 0.001; I2 = 98%) or migraine (OR, 1.32, 95% CI = 1.18-1.47; P < 0.001; I2 = 98.9%). Most of the results of the subgroup analyses were consistent with the overall results.Conclusion
The findings of this meta-analysis suggest that atopic dermatitis is a potential risk indicator for headache disorder or migraine. Further studies are still needed to verify our findings due to the substantial heterogeneity in our analyses.
SUBMITTER: Yang W
PROVIDER: S-EPMC10991782 | biostudies-literature | 2024
REPOSITORIES: biostudies-literature
Publications
Association of atopic dermatitis and headache disorder: a systematic review and meta-analyses.
Yang Wei W Dai Hong H Xu Xiao-Feng XF Jiang Hai-Yin HY Ding Ji-Yuan JY
Frontiers in neurology 20240321
<h4>Background</h4>Growing evidence suggests that headache disorders and atopic dermatitis share similar pathological mechanisms and risk factors. The aim of this study was to assess the risk for headache disorders in patients with atopic dermatitis.<h4>Methods</h4>We systematically searched the PubMed and Embase databases from inception to December 1, 2023, for observational studies that examined risk of migraine in subjects with atopic dermatitis. Risk estimates from individual studies were po ...[more]
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Project description:BackgroundThe lack of standardized nomenclature for atopic dermatitis (AD) creates unnecessary confusion for patients, healthcare providers, and researchers. It also negatively impacts accurate communication of research in the scientific literature. We sought to determine the most commonly used terms for AD.MethodsA systematic review of the MEDLINE, EMBASE, and LILACS (1945-2016) for the terms AD, atopic eczema (AE), and multiple other eczematous disorders.ResultsIn MEDLINE, 33 060 were identified, of which 21 299 (64.4%) publications used the term 'AD', 15 510 (46.9%) 'eczema', and only 2471 (7.5%) AE. Most of these publications used the term AD (82.0%) or eczema (70.8%) without additional nomenclature; only 1.2% used AE alone. Few publications used the terminology 'childhood eczema', 'flexural eczema', 'infantile eczema', 'atopic neurodermatitis', or 'Besnier's prurigo'. AD was rarely used until the late 1970s, after which it became the most commonly used of the three terms and continuously increased until 2015. Atopic eczema decreased between 2008 and 2015. Atopic dermatitis was the most commonly used term in studies across almost all publication types, languages, and journals.ConclusionAtopic dermatitis is the most commonly used term and appears to be increasing in popularity. Given that eczema is a nonspecific term that describes the morphological appearance of several forms of dermatitis, we strongly suggest the use of a more specific term, AD, in publications, healthcare clinician training, and patient education. Support from researchers, reviewers, and editors is key to success.
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Project description:ObjectivesAtopic dermatitis is a chronic, relapsing, inflammatory skin disease that impacts patients' quality of life and imposes substantial economic burdens on their families. Acupuncture holds promise as a viable treatment option for atopic dermatitis. This review aimed to evaluate the effect of acupuncture on atopic dermatitis.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, CENTRAL, the China National Knowledge Infrastructure, WanFang and VIP databases were searched through 17 September 2023, together with an updated search on 15 October 2024.Eligibility criteria for selecting studiesWe included randomised controlled trials (RCTs) about acupuncture for atopic dermatitis. The primary outcome was the SCORing Atopic Dermatitis (SCORAD) score. The secondary outcomes were the eczema area and severity index (EASI) score, the visual analogue scale (VAS) score for pruritus, the dermatology life quality index (DLQI) score, serum IgE level and adverse events (AEs).Data extraction and synthesisTwo independent reviewers conducted separate searches of the databases, assessed eligible articles for inclusion and employed the Cochrane Collaboration's tool for assessing the risk of bias. The analyses were performed using RevMan 5.3 and Stata 13.0 software. The mean difference (MD) with 95% CI was employed to analyse continuous outcomes.ResultsEight studies with 463 participants were included. The meta-analysis indicated significant differences in the SCORAD score (MD=-10.61, 95% CI -17.77 to -3.45, p=0.004), the VAS score for pruritus (MD=-14.71, 95% CI -18.20 to -11.22, p<0.00001) and the DLQI score (MD=-2.37, 95% CI -3.57 to -1.18, p<0.0001), but no significant differences in the EASI score (MD=-3.95, 95% CI -8.35 to 0.45, p=0.08) and the IgE level (MD=-160.22 U/mL, 95% CI -334.13 to 13.68, p=0.07) between treatment and control. The differences in the SCORAD score and the VAS score for pruritus reached minimal clinically important differences. No serious AEs were reported.ConclusionsAcupuncture might be an effective and safe treatment for atopic dermatitis. Due to the limited quantity and quality of the included studies, it is recommended to conduct multicentre, large-scale and high-quality RCTs to further confirm the findings.Prospero registration numberCRD42023470643.
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Project description:ImportanceThere are multiple approved systemic treatments for atopic dermatitis. Lebrikizumab is a newly licensed biologic medication that has been compared to placebo in clinical trials but not to other systemic treatments.ObjectiveTo compare reported measures of efficacy and safety of lebrikizumab to other systemic treatments for atopic dermatitis in a living systematic review and network meta-analysis.Data sourcesThe Cochrane Central Register of Controlled Trials, MEDLINE, Embase, the Latin American and Caribbean Health Science Information database, the Global Resource of Eczema Trials database, and trial registries were searched from inception through November 3, 2023.Study selectionRandomized clinical trials evaluating 8 or more weeks of treatment with systemic immunomodulatory medications for moderate to severe atopic dermatitis. Titles, abstracts, and full texts were screened in duplicate.Data extraction and synthesisData were abstracted in duplicate and random-effects bayesian network meta-analyses were performed. Minimal important differences were used to define important differences between medications. Certainty of evidence was assessed using the GRADE approach (Grading of Recommendations Assessment, Development and Evaluation). The updated analysis was completed from December 13, 2023, to February 20, 2024.Main outcome measuresEfficacy outcomes were the Eczema Area and Severity Index (EASI), the Patient Oriented Eczema Measure (POEM) Dermatology Life Quality Index (DLQI), and Peak Pruritus Numeric Rating Scales (PP-NRS) and were compared using mean difference (MD) with 95% credible intervals (CrI). Safety outcomes were serious adverse events and withdrawal due to adverse events. Other outcomes included the proportion of participants with 50%, 75%, and 90% improvement in EASI (EASI-50, -75, -90) and the proportion with success on the Investigator Global Assessment compared using odds ratios with 95% CrI.ResultsThe study sample included 97 eligible trials, with a total of 24 679 patients. Lebrikizumab was associated with no important difference in change in EASI (MD, -2.0; 95% CrI, -4.5 to 0.3; moderate certainty), POEM (MD, -1.1; 95% CrI -2.5 to 0.2; moderate certainty), DLQI (MD, -0.2; 95% CrI -2.1 to 1.6; moderate certainty), or PP-NRS (MD, 0.1; 95% CrI -0.4, 0.6; high certainty) compared to dupilumab among adults with atopic dermatitis who were treated for up to 16 weeks. Dupilumab was associated with higher odds of efficacy in binary outcomes compared with lebrikizumab. The relative efficacy of other approved systemic medications was similar to that found by previous updates of this living study, with high-dose upadacitinib and abrocitinib demonstrating numerically highest relative efficacy. For safety outcomes, low event rates limited useful comparisons.Conclusions and relevanceIn this living systematic review and network meta-analysis, lebrikizumab was similarly effective to dupilumab for the short-term treatment of atopic dermatitis in adults. Clinicians and patients can use these comparative data to inform treatment decisions.
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