Background:

Asthma and other atopic disorders, such as allergic rhinitis (AR) and atopic dermatitis (AD) often co-occur. Whether this is linked with asthma severity in moderate to severe pediatric asthma is unclear.

Aim:

To investigate whether moderate to severe asthmatic children with AR and/or AD are at risk of more asthma-related hospital visits.

Methods:

A cross-sectional analysis of 128 children (6-17 years) included in the Systems Pharmacology approach to uncontrolled Pediatric Asthma (SysPharmPediA) study. Children (GINA treatment step ? 3) were included from Germany, the Netherlands, Slovenia, and Spain. AR and AD were based on doctor-diagnosis ever. The main outcome was ?1 asthma-related hospital admission or ER visit in the past year. Multivariable logistic regression models were fitted to evaluate the risk of hospital visits among children with or without comorbid atopic disorders.

Results:

Only 23 children (18%) did not have AR and/or AD. Children with at least one atopic disorder had a lower risk of hospital visits compared to the children without AR or AD (adjusted OR(95%CI): 0.08(0.02, 0.37)). The amounts of inhaled corticosteroid (ICS) used were significantly higher in the group without AR or AD. The group without AR or AD showed a higher reversibility response to salbutamol and blood neutrophil counts. FEV1% predicted and blood eosinophil counts were significantly lower in the no AR-AD group.

Conclusions:

In this moderate to severe pediatric asthma population, children without comorbid atopic disorders (AR or AD) were at increased risk of hospital visits, despite higher ICS intake.