Early Food Allergy May Increase Odds of Atopic March

Medscape

14-05-2025

In children with early-onset atopic dermatitis, the presence of food allergy by age 36 months was associated with an increased risk for atopic march, including moderate to severe asthma, allergic rhinitis, and anaphylaxis, by age 11 years.
METHODOLOGY:
To assess the impact of food allergies on the progression of atopic dermatitis to other atopic disorders, researchers analyzed electronic health records from 10,688 children (57.5% boys) who had atopic dermatitis by 36 months of age.
Of these children, 2273 had probable food allergies.
The investigators examined the association between baseline child and maternal characteristics and the development of moderate to severe asthma, allergic rhinitis, and anaphylaxis between the ages of 5 years and 11 years.
TAKEAWAY:
Children with food allergies had a 42% higher risk of developing moderate to severe asthma, a 34% higher risk of developing allergic rhinitis, and a 69% higher risk of developing anaphylaxis between ages 5 years and 11 years than those without food allergies ( P < .001 for all).
< .001 for all). Compared with children without food allergies, those with food allergies were more likely to receive systemic corticosteroids (13.9% vs 23.8%) and had a higher prevalence of eosinophilic esophagitis (< 0.01% vs 0.5%; P < .001 for all).
< .001 for all). Children with food allergies were more likely to have elevated blood eosinophil levels and had more consultations with allergists and dermatologists.
IN PRACTICE:
The findings 'strongly support the importance of early-onset food allergy as an additive atopic disorder in promoting the atopic march' in children with atopic dermatitis, the authors wrote. 'Food allergy enhances both present and future atopic conditions, including asthma, allergic rhinitis, anaphylaxis, eosinophilic esophagitis, allergen sensitization, and elevated levels of blood eosinophils.'
SOURCE:
Robert S. Zeiger, MD, PhD, with Kaiser Permanente Southern California, San Diego, was the corresponding author of the study, which was published online on May 7 in The Journal of Allergy and Clinical Immunology: In Practice .
LIMITATIONS:
Not all probable food allergy diagnoses were definitively confirmed. Laboratory testing was inconsistent.
DISCLOSURES:
This study was supported by Sanofi and Regeneron Pharmaceuticals. Some authors were employees of Sanofi, Regeneron, or Aesara. Zeiger had received grant support from ALK-Abelló, AstraZeneca, Blueprint Technologies, Merck, Sanofi, and the National Heart, Lung, and Blood Institute. He also had received consultant fees from AstraZeneca and Merck and warrants from DBV Technologies.