Coexistence of asthma, rhinitis, eczema very rare

As few as 2 percent of the general adult population have concomitant asthma, rhinitis, and eczema, according to data from the West Sweden Asthma Study. Furthermore, individuals with the three conditions are most likely to be sensitized to aeroallergens.

The West Sweden Asthma Study assessed the phenotypes and sensitization profiles of 1,103 randomly selected individuals. All participants had their serum-IgE measured and responded to structured interviews on asthma, rhinitis, eczema, their associated symptoms, and relevant risk factors.

Most of the participants were women (53 percent), who were also generally younger than men (mean age 46.2 vs 49.2 years). Compared with men, more women were current smokers (13 percent vs 19 percent), had body mass index <25 kg/m² (45 percent vs 29 percent), and had a family history of asthma and/or allergy (41 percent vs 32 percent). Meanwhile, men were considerably more often exposed to gas, dust, or fumes at work (36 percent vs 15 percent) and more commonly had specific sensitization as demonstrated with positive Phadiatop test (36 percent vs 24 percent).

The prevalence of current asthma, rhinitis, and eczema was 13 percent, 53 percent, and 14 percent, respectively. The prevalence of concomitant asthma, rhinitis, and eczema was 2 percent in the overall population and 6 percent in the subgroup of individuals with allergic sensitization. Corresponding figures for asthma and rhinitis, but not eczema, was 8 percent and 19 percent, respectively.

Determinants of coexistence of the three conditions included family history of asthma/allergy, body mass index, and occupational exposure to gas, dust and fumes.

Allergic sensitization was found in 78 percent of individuals with asthma, rhinitis, and eczema; 65 percent of those with asthma and rhinitis but not eczema; 40 percent of those with asthma and eczema but not rhinitis; and only 5 percent of those having asthma only.

The findings may be valuable in consideration of the development of new treatment opportunities for chronic obstructive airway diseases and allergies, especially of monoclonal antibody targeting the interleukin (IL)4/IL13 pathway, which is indicated for treatment of both severe asthma and atopic eczema.