Five-year outcomes of the STOP-AD randomised controlled trial: Long-term effects of early emollient therapy in high-risk infants.

What was studied

This study reports the 5-year follow-up of the STOP-AD trial. Earlier results showed less atopic dermatitis (AD). That followed short early emollient use in infants at high risk. This follow-up asked if the effect lasts beyond infancy. The babies were born at term and at high risk of AD. They were assigned by chance within 4 days of birth. One group had whole-body emollient for the initial 8 weeks of life. The other group had standard routine skin care. Assessors, blind to group, examined the children in person at age 5. The main outcome was how many had AD at 5 years. Severity was also assessed with SCORAD. Multiple imputation tested the effect of missing data.

What they found

177 children finished the 5-year follow-up. The AD rate at 5 years was 12.3 in the intervention group. It was 24.0 in the control group. The risk ratio was 0.52. The range was 0.26 to 1.02. Children with AD had a lower median SCORAD with the intervention. It was 12.0 versus 19.6. After multiple imputation, the effect looked similar. The odds ratio was 0.45, with a range of 0.19 to 1.03. Uncertainty was greater.

What it means for patients

The authors say brief early emollient use went with less AD at 5 years. It also went with milder AD. This was in high-risk children. They say the effect stayed similar after multiple imputation. They say uncertainty from attrition remained. They say short early barrier support may shape later AD. They say timing and formulation need more study.

Why it is not certain yet

Uncertainty from attrition remained. The range around the main risk ratio ran up to 1.02. The range after multiple imputation ran up to 1.03. This was a single-centre trial. A single trial can only show so much.

Source

Five-year outcomes of the STOP-AD randomised controlled trial: Long-term effects of early emollient therapy in high-risk infants.

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