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

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, KimS.; Allen, Hilary; Cork, Michael J.; Kelleher, Maeve M.; Simpson, Eric L.; Lartey, Stella T.; Davies‐Jones, Susan; Boyle, Robert J.; Williams, Hywel C

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Authors

LAURA WYATT Laura.Wyatt@nottingham.ac.uk
Clinical Trial Manager

Sara J. Brown

Rachel H. Haines

ALAN MONTGOMERY ALAN.MONTGOMERY@NOTTINGHAM.AC.UK
Director Nottingham Clinical Trials Unit

Michael R. Perkin

Sandra Lawton

Tracey H. Sach

Joanne R. Chalmers

Matthew J. Ridd

Carsten Flohr

Joanne Brooks

Richard Swinden

Stella Tarr

Nicola Jay

Hilary Allen

Michael J. Cork

Maeve M. Kelleher

Eric L. Simpson

Stella T. Lartey

Susan Davies‐Jones

Robert J. Boyle

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HYWEL WILLIAMS HYWEL.WILLIAMS@NOTTINGHAM.AC.UK
Professor of Dermato-Epidemiology



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.

Citation

Bradshaw, L. E., Wyatt, L. A., Brown, S. J., Haines, R. H., Montgomery, A. A., Perkin, M. R., …Williams, H. C. (2023). Emollients for prevention of atopic dermatitis: 5‐year findings from the BEEP randomized trial. Allergy, 78(4), 995-1006. https://doi.org/10.1111/all.15555

Journal Article Type Article
Acceptance Date Sep 22, 2022
Online Publication Date Nov 3, 2022
Publication Date 2023-04
Deposit Date Oct 31, 2022
Publicly Available Date Nov 4, 2023
Journal Allergy
Print ISSN 0105-4538
Electronic ISSN 1398-9995
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 78
Issue 4
Pages 995-1006
DOI https://doi.org/10.1111/all.15555
Keywords asthma, atopic dermatitis, food allergy, prevention, rhinitis
Public URL https://nottingham-repository.worktribe.com/output/13168995
Publisher URL https://onlinelibrary.wiley.com/doi/10.1111/all.15555

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