highlighted associations between atopic dermatitis (AD) and mental health conditions in adults. However, literature on the development of mental health comorbidities in children is limited despite the large burden of pediatric AD worldwide.OBJECTIVE To examine the association between AD and internalizing behaviors and symptoms of depression at multiple points across childhood and adolescence and to explore potential mediating factors, including asthma/rhinitis, sleep, and inflammation.
DESIGN, SETTING, AND PARTICIPANTSThis longitudinal, population-based birth cohort study included children followed up from birth for a mean (SD) duration of 10.0 (2.9) years from the
The majority of data regarding immunotherapy for melanoma stems from trials that exclude important populations. Thus, while trials may demonstrate favorable results, not all populations may be represented. To evaluate factors affecting the utilization of immunotherapy and to stratify results based on the approval of ipilimumab in 2011 and PD-1 inhibitors in 2014, an analysis of available data from the National Cancer Database (NCDB) was performed. Stage IV melanoma patients were identified. Effects of immunotherapy on overall survival (OS) were assessed using Kaplan Meier curves and Cox proportional hazards model. 19,233 patients were analyzed, of whom, 1,998 received immunotherapy. Between 2011-2013, and in 2014, 18.6% and 28.9% of patients received immunotherapy, respectively. Younger patients and those with fewer co-morbidities or receiving care in an academic institution were more likely to receive immunotherapy. Patients without insurance were less likely to receive immunotherapy. Patients who received immunotherapy from 2011-2013 had a 33% (95% CI 30-35%) 3-year OS compared to 23% (95% CI 21-24%) for those who did not. In 2014, 3-year OS was 37% (95% CI 32-43%) for those who received immunotherapy compared to 22% (95% CI 18-26%) for those who did not (log-rank p<0.0001). This is the first analysis of a large cancer database for patients with any cancer with stratification of results based on utilization and availability of immunotherapy. Immunotherapy utilization increased yearly and improved OS. With combination immunotherapy now more widely employed, it is expected these results will continue to improve.
OBJECTIVES/GOALS: Atopic dermatitis is one of the most common chronic childhood conditions worldwide and is associated with poor mental health outcomes. Our aim is to determine whether childhood atopic dermatitis is associated with symptoms of depression throughout childhood and adolescence, and whether this association is mediated by serum inflammatory markers. METHODS/STUDY POPULATION: We will perform a longitudinal analysis of over 7000 children from an existing prospective cohort. The primary exposure is atopic dermatitis (AD) annual period prevalence measured by a standardized questionnaire at 12 time points between age 6 months and 16 years. Depression is measured using self-reported responses to the Short Moods and Feelings Questionnaire at 6 time points between 10 and 18 years of age. Cross-sectional regression analyses will be performed to compare depressive signs between children with and without AD and test for dose-response effects with AD and depression. Longitudinal analyses will be conducted using mixed-effects models to estimate the average effect across childhood. We will complete a mediation analysis to determine the extent to which IL-6 and CRP mediate this association. RESULTS/ANTICIPATED RESULTS: We anticipate that atopic dermatitis will be associated with SMFQ scores in a dose response relationship, and that inflammatory markers CRP and IL-6 will partly mediate this association. DISCUSSION/SIGNIFICANCE OF IMPACT: Childhood is a critical time for mental health. Understanding the longitudinal relationship between atopic dermatitis, depression, and inflammatory mediators is crucial as new biologic treatments targeting inflammatory cascades are approved for atopic dermatitis and have the potential to prevent mental health conditions.
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