Analysis of the Influence of Sex in 507 Patients With Moderate-to-Severe Atopic Dermatitis: Spanish Atopic Dermatitis Registry (BIOBADATOP).

INTRODUCTION

Atopic dermatitis (AD) is a common chronic inflammatory disease that presents differences in clinical expression according to sex. The aim of this study was to evaluate the influence of sex on disease severity, comorbidities, treatments, and adverse events in patients with moderate-to-severe AD included in the Spanish BIOBADATOP registry.

METHODS

We conducted a prospective observational study using data from the BIOBADATOP registry from March 2020 to February 2025. Demographic variables, severity scales (EASI, DLQI, POEM, pruritus VAS), comorbidities, treatments, and adverse events were collected. Statistical analysis was performed using Chi-square, Student's t-test, and Mann-Whitney tests, considering statistical significance at P<.05.

RESULTS

A total of 507 adult patients on systemic treatment were included (53.1% men, 46.9% women). Men showed greater disease severity according to EASI (21.7 vs 21.0) and higher serum IgE levels (1323 vs 638KU/L). Women reported greater pruritus intensity and worse POEM scores. Anxiety (26% vs 13%) and depression (15% vs 5%) were more frequent among women. No differences were observed in family history or atopic comorbidities. Similarly, no relevant differences were found in treatments received, treatment duration, or clinical response at 3, 6, and 12 months. However, women showed a higher rate of GI adverse events (97/1000 vs 19/1000 patient-years).

CONCLUSIONS

Clinical and comorbidity differences according to sex exist in moderate-to-severe AD. Men show greater disease severity and higher IgE levels, whereas women experience a greater perceived disease burden, pruritus, psychiatric comorbidities, and more GI adverse events. These findings support the need to consider sex as a factor in the evaluation and comprehensive management of AD.