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Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial
Author(s) -
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.,
DaviesJones Susan,
Boyle Robert J.,
Williams Hywel C.
Publication year - 2023
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.15555
Subject(s) - medicine , atopic dermatitis , moisturizer , hay fever , allergy , randomized controlled trial , cumulative incidence , food allergy , asthma , incidence (geometry) , confidence interval , dermatology , atopy , relative risk , immunology , chemistry , transplantation , physics , food science , optics
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.