Skip to main content

Research Repository

Advanced Search

What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials

Nankervis, Helen; Thomas, K.S.; Delamere, Finola M.; Barbarot, S.; Smith, S.; Rogers, Natasha K.; Williams, Hywel C.

Authors

Helen Nankervis

K.S. Thomas

Finola M. Delamere

S. Barbarot

S. Smith

Natasha K. Rogers

Hywel C. Williams



Abstract

Atopic eczema (AE) is a common chronic inflammatory skin condition. Whilst many AE treatment options are available, the evidence to support their efficacy varies in depth and quality. In 2000, an NIHR HTA systematic review identified and evaluated existing randomised controlled trials (RCTs) of AE treatments. To ensure continuing utility, the NIHR commissioned an update to the review. Here, we present an overview of the updated report and key findings.
Systematic reviews and RCTs of AE treatments that included participants with AE (criteria based or diagnosed) were identified using: MEDLINE, EMBASE, CENTRAL, LILACS, AMED, CINAHL and Cochrane Skin Group Specialised Register (searched to August 31st 2013 (RCTs) and 31st December 2015 (systematic reviews)). Outcome measures included: symptoms, AE severity, quality-of-life, and adverse effects. Study quality was assessed using the Cochrane Collaboration risk of bias tool.
Of the 287 new RCTs identified, only 22 (8%) were judged to be low risk of bias. When combined with RCTs from the previous review (n= 254), we found ‘reasonable evidence of benefit’ for corticosteroids, calcineurin inhibitors, Atopiclair™, ciclosporin, azathioprine, ultraviolet light and education programmes.
Interventions with reasonable evidence of ‘no benefit’ included some dietary interventions, ion exchange water softeners, multiple daily applications of topical corticosteroids and antibiotic-containing corticosteroids for non-infected AE. Many common treatments lack evidence of efficacy and warrant further evaluation.
The evidence base for AE is still hampered by poor trial design and reporting. The trials included in this review were used to establish the Global Resource of Eczema Trials (GREAT) Database.

Citation

Nankervis, H., Thomas, K., Delamere, F. M., Barbarot, S., Smith, S., Rogers, N. K., & Williams, H. C. (in press). What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials. British Journal of Dermatology, 176(4), https://doi.org/10.1111/bjd.14999

Journal Article Type Article
Acceptance Date Aug 8, 2016
Online Publication Date Aug 22, 2016
Deposit Date Aug 30, 2016
Publicly Available Date Aug 30, 2016
Journal British Journal of Dermatology
Print ISSN 0007-0963
Electronic ISSN 1365-2133
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 176
Issue 4
DOI https://doi.org/10.1111/bjd.14999
Keywords Eczema, atopic dermatitis, treatment, systematic review
Public URL http://eprints.nottingham.ac.uk/id/eprint/36094
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/bjd.14999/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf

Files


What is the evidence-base for atopic eczema treatments A summary of published randomised controlled trials.pdf (4.8 Mb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





You might also like



Downloadable Citations