2nd Dermatology Clinic, Colentina Clinical Hospital, "Carol Davila" University of Medicine, Bucharest, Romania.
Pediatric Dermatology unit, Hôpital Pellegrin-Enfants, CHU Bordeaux, University Hospital of Bordeaux, Bordeaux, France.
J Eur Acad Dermatol Venereol. 2018 Jul;32(7):1180-1187. doi: 10.1111/jdv.14849. Epub 2018 Mar 9.
Emollients are considered as a first-line therapy for the treatment of atopic dermatitis (AD). However, evidence-based proof that the regular use of emollients reduces AD severity is lacking.
To assess whether the regular use of emollients results in a reduction in AD severity in children with AD.
In this multicentre randomized, parallel group, open-label study, children with mild-to-moderate AD were recruited during a flare. After flare resolution with a topical corticosteroid, patients were randomized to V0034CR emollient, reference emollient or no emollient (1:1:1 ratio), for 12 weeks. AD severity was assessed regularly by physicians [Scoring for Atopic Dermatitis (SCORAD) and subcomponents, IGA] and by parents (PO-SCORAD and POEM).
A total of 335 patients were randomized to V0034CR (n = 111), reference emollient (n = 116) or no emollient (n = 108). After 12 weeks of treatment, SCORAD score was reduced by 5.28 points in the V0034CR group and by 3.36 points in the reference emollient group compared with the no emollient group (+4 points; P < 0.001 in both emollient groups vs. no emollient group). In a similar manner, PO-SCORAD score was reduced by 4.88 and 2.67 points in the V0034CR and reference emollient groups, respectively, but increased by 2.90 points in the no emollient group (P < 0.001). Similar results were observed for POEM. A continuous decrease in all scores was observed over the 12-week treatment period. At the end of the study, the percentage of patients in complete remission (i.e. without a new flare over the treatment period) was higher in the V0034CR (59.5%) and reference emollient (44.3%) groups than in the no emollient group (29.8%; P < 0.001).
These results demonstrate that the regular use of emollients in children with mild-to-moderate AD reduces the severity of symptoms and, therefore, support their use as a first-line treatment for these patients.
保湿剂被认为是治疗特应性皮炎（AD）的一线疗法。然而，缺乏证据表明常规使用保湿剂可以降低 AD 的严重程度。
评估常规使用保湿剂是否会降低 AD 患儿 AD 的严重程度。
在这项多中心随机、平行分组、开放性研究中，招募了在发作期患有轻度至中度 AD 的儿童。在局部皮质类固醇治疗缓解发作后，患者被随机分配至 V0034CR 保湿剂、参考保湿剂或无保湿剂（1:1:1 比例），治疗 12 周。医生[特应性皮炎评分（SCORAD）和亚组分、IGA]和家长[患者整体评分（PO-SCORAD）和家长整体评估（POEM）]定期评估 AD 严重程度。
共有 335 名患者被随机分配至 V0034CR（n = 111）、参考保湿剂（n = 116）或无保湿剂（n = 108）组。治疗 12 周后，V0034CR 组 SCORAD 评分降低 5.28 分，参考保湿剂组降低 3.36 分，无保湿剂组升高 4 分（V0034CR 组和参考保湿剂组均显著优于无保湿剂组，P < 0.001）。同样，V0034CR 组和参考保湿剂组 PO-SCORAD 评分分别降低 4.88 和 2.67 分，无保湿剂组升高 2.90 分（P < 0.001）。POEM 也观察到相似的结果。在 12 周的治疗期间，所有评分均呈持续下降趋势。研究结束时，V0034CR（59.5%）和参考保湿剂（44.3%）组完全缓解（即治疗期间无新发作）的患者比例高于无保湿剂组（29.8%；P < 0.001）。
这些结果表明，在患有轻度至中度 AD 的儿童中常规使用保湿剂可降低症状严重程度，因此支持将其作为这些患者的一线治疗方法。
