Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial. Issue 4 (3rd November 2022)

• Record Type: Journal Article
• Authors: Bradshaw, Lucy E.; Wyatt, Laura A.; Brown, Sara J.; Haines, Rachel H.; Montgomery, Alan A.; Perkin, Michael R.; Lawton, Sandra; Sach, Tracey H.; Chalmers, Joanne R.; Ridd, Matthew J.; Flohr, Carsten; Brooks, Joanne; Swinden, Richard; Mitchell, Eleanor J.; Tarr, Stella; Jay, Nicola; Thomas, Kim S.; Allen, Hilary; Cork, Michael J.; Kelleher, Maeve M.; Simpson, Eric L.; Lartey, Stella T.; Davies‐Jones, Susan; Boyle, Robert J.; Williams, Hywel C.
• Is Part Of: Allergy. Volume 78:Issue 4(2023)
• Page Start: 995
• Page End: 1006
• Publication Date: 2022-11-03
• Subjects: asthma -- atopic dermatitis -- food allergy -- prevention -- rhinitis; Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.15555
• Languages: English
• ISSNs: 0105-4538

Abstract

Abstract: 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. Abstract : Graphical Abstract1394 newborns at high risk of atopic dermatitis randomized to either daily emollients (Doublebase Gel [Dermal Laboratories] or Diprobase Cream [Bayer]) for 12 months or standard skin care advice. Regular emollients did not prevent atopic dermatitis, food allergy, asthma or allergic rhinitis during the first 5 years of life. Severity of atopic dermatitis similar in the two groups at 5 years.Abbreviation: AD, atopic dermatitis