Five-year outcomes of the STOP-AD randomised controlled trial: Long-term effects of early emollient therapy in high-risk infants.
Molly L Cremin, Sadhbh Hurley, Claire O'Halloran et al.
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In 30 seconds
This blinded, single-centre, randomised controlled trial follow-up assessed whether brief neonatal emollient use was associated with lasting effects on atopic dermatitis (AD) in term infants at high risk of AD. Infants had been assigned to twice-daily whole-body emollient or routine skin care for the first 8 weeks of life; 177 children completed assessment at 5 years. AD prevalence was lower after emollient use (12.3% vs. 24.0%; RR 0.52, 95% CI 0.26-1.02; p = .048), and severity among affected children was also lower. The authors note that attrition leaves uncertainty.
Key findings
- At 5 years, AD point prevalence was 12.3% with early emollient use versus 24.0% with routine skin care (RR 0.52, 95% CI 0.26-1.02; p = .048).
- Among children with AD, median SCORAD was 12.0 [IQR 8.2-15.2] in the intervention group versus 19.6 [IQR 11.8-23.4] in controls (p = .034).
- Multiple imputation gave a similar estimated effect, but with greater uncertainty (OR 0.45, 95% CI 0.19-1.03; p = .060).
Why it matters
The findings suggest that a short intervention begun in the neonatal period may be associated with differences in both AD prevalence and severity years later. This extends the question of skin-barrier prevention beyond infancy, while the uncertainty around the imputed estimate and the need for further investigation mean the result should be interpreted cautiously.
What to keep in mind
This was a single-centre trial follow-up, and attrition left uncertainty despite multiple imputation. The imputed estimate had a confidence interval spanning 1.0.