Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial.

Autor: Bradshaw LE; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Wyatt LA; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Brown SJ; Skin Research Group, School of Medicine, University of Dundee, Dundee, UK.; Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK., Haines RH; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Montgomery AA; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Perkin MR; Population Health Research Institute, St. George's University of London, London, UK., Lawton S; Rotherham NHS Foundation Trust, UK., Sach TH; Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK., Chalmers JR; Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK., Ridd MJ; Population Health Sciences, University of Bristol, Bristol, UK., Flohr C; Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK., Brooks J; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Swinden R; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Mitchell EJ; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Tarr S; Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK., Jay N; Sheffield Children's Hospital, Sheffield, UK., Thomas KS; Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK., Allen H; National Heart and Lung Institute, Imperial College London, London, UK., Cork MJ; Sheffield Dermatology Research, Department of Infection and Immunity, University of Sheffield, Sheffield, UK., Kelleher MM; National Heart and Lung Institute, Imperial College London, London, UK., Simpson EL; Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA., Lartey ST; Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK., Davies-Jones S; Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK., Boyle RJ; Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.; National Heart and Lung Institute, Imperial College London, London, UK., Williams HC; Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.
Jazyk: angličtina
Zdroj: Allergy [Allergy] 2023 Apr; Vol. 78 (4), pp. 995-1006. Date of Electronic Publication: 2022 Nov 03.
DOI: 10.1111/all.15555
Abstrakt: Background: The effectiveness of emollients for preventing atopic dermatitis/eczema is controversial. The Barrier Enhancement for Eczema Prevention trial evaluated the effects of daily emollients during the first year of life on atopic dermatitis and atopic conditions to age 5 years.
Methods: 1394 term infants with a family history of atopic disease were randomized (1:1) to daily emollient plus standard skin-care advice (693 emollient group) or standard skin-care advice alone (701 controls). Long-term follow-up at ages 3, 4 and 5 years was via parental questionnaires. Main outcomes were parental report of a clinical diagnosis of atopic dermatitis and food allergy.
Results: Parents reported more frequent moisturizer application in the emollient group through to 5 years. A clinical diagnosis of atopic dermatitis between 12 and 60 months was reported for 188/608 (31%) in the emollient group and 178/631 (28%) in the control group (adjusted relative risk 1.10, 95% confidence interval 0.93 to 1.30). Although more parents in the emollient group reported food reactions in the previous year at 3 and 4 years, cumulative incidence of doctor-diagnosed food allergy by 5 years was similar between groups (92/609 [15%] emollients and 87/632 [14%] controls, adjusted relative risk 1.11, 95% confidence interval 0.84 to 1.45). Findings were similar for cumulative incidence of asthma and hay fever.
Conclusions: Daily emollient application during the first year of life does not prevent atopic dermatitis, food allergy, asthma or hay fever.
(© 2022 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: