Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema

Thomas, K.S.; Armstrong, S.J.; Avery, Anthony; Li Wan Po, A.; O'Neill, C.; Young, S.; Williams, H.C.

Abstract

Objective To determine whether a three day burst of
a potent corticosteroid is more effective than a mild
preparation used for seven days in children with mild
or moderate atopic eczema.
Design Randomised, double blind, parallel group
study of 18 weeks' duration.
Setting 13 general practices and a teaching hospital
in the Nottingham area.
Participants 174 children with mild or moderate
atopic eczema recruited from general practices and
33 from a hospital outpatient clinic.
Interventions 0.1% betamethasone valerate applied
for three days followed by the base ointment for four
days versus 1% hydrocortisone applied for seven days.
Main outcome measures Primary outcomes were
total number of scratch­free days and number of
relapses. Secondary outcomes were median duration
of relapses, number of undisturbed nights, disease
severity (six area, six sign atopic dermatitis severity
scale), scores on two quality of life measures
(children's life quality index and dermatitis family
impact questionnaire), and number of patients in
whom treatment failed in each arm.
Results No differences were found between the two
groups. This was consistent for all outcomes. The
median number of scratch­free days was 118.0 for the
mild group and 117.5 for the potent group (difference
0.5, 95% confidence interval - 2.0 to 4.0, P = 0.53).
The median number of relapses for both groups was
1.0. Both groups showed clinically important
improvements in disease severity and quality of life
compared with baseline.
Conclusion A short burst of a potent topical
corticosteroid is just as effective as prolonged use of a
milder preparation for controlling mild or moderate
atopic eczema in children.

Citation

Thomas, K., Armstrong, S., Avery, A., Li Wan Po, A., O'Neill, C., Young, S., & Williams, H. (2002). Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema. British medical journal, 324(7340),

• Journal Article Type: Article
• Publication Date: Mar 30, 2002
• Deposit Date: Mar 20, 2008
• Publicly Available Date: Mar 20, 2008
• Journal: British Medical Journal
• Print ISSN: 0007-1447
• Peer Reviewed: Peer Reviewed
• Volume: 324
• Issue: 7340
• Public URL: https://nottingham-repository.worktribe.com/output/702964
• Related Public URLs: http://www.bmj.com/