Rhinitis prevalence and association with atopic dermatitis: A systematic review and meta-analysis.

Background Atopic dermatitis (AD) and rhinitis are common atopic diseases that may co-occur due to an overlap in pathophysiology. While most cases of both diseases are mild and managed with topical anti-inflammatory medicaments, the advent of new systemic and biologic treatments targeting type 2 inflammation in both diseases warrant further insight in the exact overlap of AD and rhinitis. Objective To determine the association between AD and rhinitis. Methods A systematic review and meta-analysis of the databases Pubmed, Embase and CNKI was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled prevalence and pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. Results The search resulted in 10,422 citations, and, respectively, 341 articles and 302 were included in the qualitative and quantitative analyses. The pooled prevalence of rhinitis was 40.5% (95% CI 39.0-42.0) in patients with atopic dermatitis and 18.0% (95% CI 16.7-19.2) in the reference individuals without atopic dermatitis. The pooled prevalence of having both rhinitis and asthma was 14.2% (95% CI 13.0-15.5) in patients with AD. There was an association between AD and, respectively, rhinitis (OR 3.00, 95% CI 2.83-3.18), allergic rhinitis (OR 3.25, 95% CI 2.26-4.66) and non-allergic rhinitis (OR 1.99, 95% CI 1.39-2.86). Conclusion Rhinitis, both allergic and non-allergic forms, is very common in patients with AD. Future investigations should clarify how medications targeting both diseases should be indicated in these patients.