Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema

Tools

Thomas, K.S., Armstrong, S.J., Avery, Anthony, Li Wan Po, A., O'Neill, C., Young, S. and Williams, H.C. (2002) Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema. British Medical Journal, 324 (7340). p. 768.

Full text not available from this repository.

Abstract

Objective To determine whether a three day burst of

a potent corticosteroid is more effective than a mild

preparation used for seven days in children with mild

or moderate atopic eczema.

Design Randomised, double blind, parallel group

study of 18 weeks' duration.

Setting 13 general practices and a teaching hospital

in the Nottingham area.

Participants 174 children with mild or moderate

atopic eczema recruited from general practices and

33 from a hospital outpatient clinic.

Interventions 0.1% betamethasone valerate applied

for three days followed by the base ointment for four

days versus 1% hydrocortisone applied for seven days.

Main outcome measures Primary outcomes were

total number of scratchfree days and number of

relapses. Secondary outcomes were median duration

of relapses, number of undisturbed nights, disease

severity (six area, six sign atopic dermatitis severity

scale), scores on two quality of life measures

(children's life quality index and dermatitis family

impact questionnaire), and number of patients in

whom treatment failed in each arm.

Results No differences were found between the two

groups. This was consistent for all outcomes. The

median number of scratchfree days was 118.0 for the

mild group and 117.5 for the potent group (difference

0.5, 95% confidence interval - 2.0 to 4.0, P = 0.53).

The median number of relapses for both groups was

1.0. Both groups showed clinically important

improvements in disease severity and quality of life

compared with baseline.

Conclusion A short burst of a potent topical

corticosteroid is just as effective as prolonged use of a

milder preparation for controlling mild or moderate

atopic eczema in children.