Impact of daily use of emollient 'plus' on corticosteroid consumption in patients with atopic dermatitis: An open, randomized controlled study.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 26 11 2022
accepted: 01 02 2023
medline: 29 5 2023
pubmed: 24 4 2023
entrez: 24 04 2023
Statut: ppublish

Résumé

Emollients are the baseline treatment for mild or moderate atopic dermatitis (AD) to improve the epidermal barrier and provide anti-irritant and anti-pruritic effects. Emollient 'plus' can influence the skin microbiome of atopic eczema patients. To evaluate the benefits of using Emollient 'plus' to reduce corticosteroid consumption. In an open, single-centre, randomized, controlled study, patients with mild to moderate AD (Severity scoring of AD [SCORAD] score 20-30) were randomized 1:1 to apply the Emollient 'plus' twice daily for 28 days or to continue with their usual classical emollient (Control group). In addition, each patient received topical corticosteroids to use when necessary and according to the dermatologist's prescription. Assessments included SCORAD, PO-SCORAD, local SCORAD, quality of life questionnaires, and tolerability. A total of 119 patients were included in the PP population with a mean age of 26.50 ± 17.5 years old (min-max 3-71 years). Between baseline and day 28, the mean amount of corticosteroid used was lower for the Emollient 'plus' versus Control group (6.03 vs. 9.16 g; p = 0.041) and corticosteroid was applied on fewer days (37.5% vs. 46.9% of days; p = 0.0256) with fewer applications per day (0.55 vs. 0.71 applications per day; p = 0.0203). Similar improvements were observed in both groups for SCORAD, PO-SCORAD, local SCORAD, skin sensation score, AD burden scale, patient benefit index >1, as well as subject and investigator efficacy and tolerability questionnaire assessments. Between baseline and day 28, there was significant corticosteroid-sparing in the Emollient 'plus' group compared to the Control group in quantity, number of applications per day and number of days of use, whilst efficacy was maintained with no significant differences between the two groups for all clinical evaluations, as well as for tolerability.

Sections du résumé

BACKGROUND BACKGROUND
Emollients are the baseline treatment for mild or moderate atopic dermatitis (AD) to improve the epidermal barrier and provide anti-irritant and anti-pruritic effects. Emollient 'plus' can influence the skin microbiome of atopic eczema patients.
OBJECTIVES OBJECTIVE
To evaluate the benefits of using Emollient 'plus' to reduce corticosteroid consumption.
METHODS METHODS
In an open, single-centre, randomized, controlled study, patients with mild to moderate AD (Severity scoring of AD [SCORAD] score 20-30) were randomized 1:1 to apply the Emollient 'plus' twice daily for 28 days or to continue with their usual classical emollient (Control group). In addition, each patient received topical corticosteroids to use when necessary and according to the dermatologist's prescription. Assessments included SCORAD, PO-SCORAD, local SCORAD, quality of life questionnaires, and tolerability.
RESULTS RESULTS
A total of 119 patients were included in the PP population with a mean age of 26.50 ± 17.5 years old (min-max 3-71 years). Between baseline and day 28, the mean amount of corticosteroid used was lower for the Emollient 'plus' versus Control group (6.03 vs. 9.16 g; p = 0.041) and corticosteroid was applied on fewer days (37.5% vs. 46.9% of days; p = 0.0256) with fewer applications per day (0.55 vs. 0.71 applications per day; p = 0.0203). Similar improvements were observed in both groups for SCORAD, PO-SCORAD, local SCORAD, skin sensation score, AD burden scale, patient benefit index >1, as well as subject and investigator efficacy and tolerability questionnaire assessments.
CONCLUSIONS CONCLUSIONS
Between baseline and day 28, there was significant corticosteroid-sparing in the Emollient 'plus' group compared to the Control group in quantity, number of applications per day and number of days of use, whilst efficacy was maintained with no significant differences between the two groups for all clinical evaluations, as well as for tolerability.

Identifiants

pubmed: 37092256
doi: 10.1111/jdv.18947
doi:

Substances chimiques

Emollients 0
Adrenal Cortex Hormones 0

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

27-34

Subventions

Organisme : La Roche-Posay

Informations de copyright

© 2023 European Academy of Dermatology and Venereology.

Références

Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657-82.
Hong J, Buddenkotte J, Berger TG, Steinhoff M. Management of itch in atopic dermatitis. Semin Cutan Med Surg. 2011;30(2):71-86.
Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-32.
Frølunde AS, Thyssen JP, Deleuran M, Vestergaard C. Appraisal of proactive topical therapy in atopic dermatitis: pros and cons. Am J Clin Dermatol. 2021;22(6):775-83.
Callen J, Chamlin S, Eichenfield LF, Ellis C, Girardi M, Goldfarb M, et al. A systematic review of the safety of topical therapies for atopic dermatitis. Br J Dermatol. 2007;156(2):203-21.
Lambrechts L, Gilissen L, Morren MA. Topical corticosteroid phobia among healthcare professionals using the TOPICOP score. Acta Derm Venereol. 2019;99(11):1004-8.
Bos B, Antonescu I, Osinga H, Veenje S, de Jong K, de Vries TW. Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers. Pediatr Dermatol. 2019;36(1):100-4.
Koster ES, Philbert D, Zheng X, Moradi N, de Vries TW, Bouvy ML. Reducing corticosteroid phobia in pharmacy staff and parents of children with atopic dermatitis. Int J Clin Pharmacol. 2021;43(5):1237-44.
Barta K, Fonacier LS, Hart M, et al. Corticosteroid exposure and cumulative effects in patients with eczema: results from a patient survey. Ann Allergy Asthma Immunol. 2022;130:93-9.e10.
Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, Kunz B, et al. ETFAD/EADV eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol. 2016;30(5):729-47.
Eichenfield LF, Ahluwalia J, Waldman A, Borok J, Udkoff J, Boguniewicz M. Current guidelines for the evaluation and management of atopic dermatitis: a comparison of the joint task force practice parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol. 2017;139(4S):S49-57.
Wollenberg A, Christen-Zäch S, Taieb A, Paul C, Thyssen JP, Bruin-Weller M, et al. ETFAD/EADV eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717-44.
Kong HH, Oh J, Deming C, Conlan S, Grice EA, Beatson MA, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22(5):850-9.
Di Domenico EG, Cavallo I, Capitanio B, Ascenzioni F, Pimpinelli F, Morrone A, et al. Staphylococcus aureus and the cutaneous microbiota biofilms in the pathogenesis of atopic dermatitis. Microorganisms. 2019;7(9):301.
Bianchi P, Theunis J, Casas C, Villeneuve C, Patrizi A, Phulpin C, et al. Effects of a new emollient-based treatment on skin microflora balance and barrier function in children with mild atopic dermatitis. Pediatr Dermatol. 2016;33(2):165-71.
Quadri M, Lotti R, Bonzano L, Ciardo S, Guanti MB, Pellacani G, et al. A novel multi-action emollient plus cream improves skin barrier function in patients with atopic dermatitis: In vitro and clinical evidence. Skin Pharmacol Physiol. 2021;34(1):8-18.
Darlenski R, Kozyrskyj AL, Fluhr JW, Caraballo L. Association between barrier impairment and skin microbiota in atopic dermatitis from a global perspective: unmet needs and open questions. J Allergy Clin Immunol. 2021;148(6):1387-93.
Gueniche A, Knaudt B, Schuck E, Volz T, Bastien P, Martin R, et al. Effects of nonpathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled clinical study. Br J Dermatol. 2008;159(6):1357-63.
Guéniche A, Dahel K, Bastien P, Martin R, Nicolas JF, Breton L. Vitreoscilla filiformis bacterial extract to improve the efficacy of emollient used in atopic dermatitis symptoms. J Eur Acad Dermatol Venereol. 2008;22(6):746-7.
Seité S, Zelenkova H, Martin R. Clinical efficacy of emollients in atopic dermatitis patients - relationship with the skin microbiota modification. Clin Cosmet Investig Dermatol. 2017;10:25-33.
Mahe YF, Perez MJ, Tacheau C, Fanchon C, Martin R, Rousset F, et al. A new Vitreoscilla filiformis extract grown on spa water-enriched medium activates endogenous cutaneous antioxidant and antimicrobial defenses through a potential toll-like receptor 2/protein kinase C, zeta transduction pathway. Clin Cosmet Investig Dermatol. 2013;6:191-6.
Kunz B, Oranje AP, Labrèze L, Stalder JF, Ring J, Taïeb A. Clinical validation and guidelines for the SCORAD index: consensus report of the European task force on atopic dermatitis. Dermatology. 1997;195(1):10-9.
Stalder JF, Barbarot S, Wollenberg A, Holm EA, de Raeve L, Seidenari S, et al. Patient-oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe. Allergy. 2011;66(8):1114-21.
Liu L, Ong G. A randomized, open-label study to evaluate an intermittent dosing regimen of fluticasone propionate 0.05% cream in combination with regular emollient skin care in reducing the risk of relapse in pediatric patients with stabilized atopic dermatitis. J Dermatolog Treat. 2018;29(5):501-9.

Auteurs

H Zelenkova (H)

SANARE spol s. r.o, Work Place: Private Dermatological Clinic, DOST, Svidník, Slovakia.

D Kerob (D)

La Roche-Posay International, Levallois-Perret, France.

S Salah (S)

La Roche-Posay International, Levallois-Perret, France.

A-L Demessant-Flavigny (AL)

La Roche-Posay International, Levallois-Perret, France.

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