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

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 t...

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Main Authors: Nankervis, Helen, Thomas, K.S., Delamere, Finola M., Barbarot, S., Smith, S., Rogers, Natasha K., Williams, Hywel C.
Format: Article
Published: Wiley 2016
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Online Access:https://eprints.nottingham.ac.uk/36094/
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author Nankervis, Helen
Thomas, K.S.
Delamere, Finola M.
Barbarot, S.
Smith, S.
Rogers, Natasha K.
Williams, Hywel C.
author_facet Nankervis, Helen
Thomas, K.S.
Delamere, Finola M.
Barbarot, S.
Smith, S.
Rogers, Natasha K.
Williams, Hywel C.
author_sort Nankervis, Helen
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-360942020-05-04T18:06:16Z https://eprints.nottingham.ac.uk/36094/ 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. 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. Wiley 2016-08-22 Article PeerReviewed Nankervis, Helen, Thomas, K.S., Delamere, Finola M., Barbarot, S., Smith, S., Rogers, Natasha K. and Williams, Hywel C. (2016) What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials. British Journal of Dermatology, 176 (4). pp. 910-927. ISSN 1365-2133 Eczema atopic dermatitis treatment systematic review http://onlinelibrary.wiley.com/doi/10.1111/bjd.14999/abstract doi:10.1111/bjd.14999 doi:10.1111/bjd.14999
spellingShingle Eczema
atopic dermatitis
treatment
systematic review
Nankervis, Helen
Thomas, K.S.
Delamere, Finola M.
Barbarot, S.
Smith, S.
Rogers, Natasha K.
Williams, Hywel C.
What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title_full What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title_fullStr What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title_full_unstemmed What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title_short What is the evidence-base for atopic eczema treatments? A summary of published randomised controlled trials
title_sort what is the evidence-base for atopic eczema treatments? a summary of published randomised controlled trials
topic Eczema
atopic dermatitis
treatment
systematic review
url https://eprints.nottingham.ac.uk/36094/
https://eprints.nottingham.ac.uk/36094/
https://eprints.nottingham.ac.uk/36094/