Temperature-controlled laminar airflow (TLA) device in the treatment of children with severe atopic eczema: Open-label, proof-of-concept study.

Autor: Gore C; Section of Paediatrics, Department of Medicine, Imperial College, London, UK.; Department of Paediatric Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK., Gore RB; Department of Respiratory Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Fontanella S; Section of Paediatrics, Department of Medicine, Imperial College, London, UK., Haider S; Section of Paediatrics, Department of Medicine, Imperial College, London, UK., Custovic A; Section of Paediatrics, Department of Medicine, Imperial College, London, UK.; Department of Paediatric Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Jazyk: angličtina
Zdroj: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology [Clin Exp Allergy] 2018 May; Vol. 48 (5), pp. 594-603. Date of Electronic Publication: 2018 Mar 13.
DOI: 10.1111/cea.13105
Abstrakt: Background: Children with severe, persistent atopic eczema (AE) have limited treatment options, often requiring systemic immunosuppression.
Objective: To evaluate the effect of the temperature-controlled laminar airflow (TLA) treatment in children/adolescents with severe AE.
Methods: We recruited 15 children aged 2-16 years with long-standing, severe AE and sensitization to ≥1 perennial inhalant allergen. Run-in period of 6-10 weeks (3 visits) was followed by 12-month treatment with overnight TLA (Airsonett ® , Sweden). The primary outcome was eczema severity (SCORAD-Index and Investigator Global Assessment-IGA). Secondary outcomes included child/family dermatology quality of life and family impact questionnaires (CDQLI, FDQLI, DFI), patient-oriented eczema measure (POEM), medication requirements and healthcare contacts. The study is registered as ISRCTN65865773.
Results: There was a significant reduction in AE severity ascertained by SCORAD and IGA during the 12-month intervention period (P < .001). SCORAD was reduced from a median of 34.9 [interquartile range 28.75-45.15] at Baseline to 17.2 [12.95-32.3] at the final visit, and IGA improved significantly from 4 [3-4] to 2 [1-3]. We observed a significant improvement in FDQLI (16.0 [12.25-19.0] to 12 [8-18], P = .023) and DFI (P = .011), but not CDQLI or POEM. Compared to 6-month period prior to enrolment, there was a significant reduction at six months after the start of the intervention in potent topical corticosteroids (P = .033). The exploratory cluster analysis revealed two strongly divergent patterns of response, with 9 patients classified as responders, and 6 as non-responders.
Conclusion and Clinical Relevance: Addition of TLA device to standard pharmacological treatment may be an effective add-on to the management of difficult-to-control AE.
(© 2018 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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