Comparison of Moisturizing Creams for the Prevention of Atopic Dermatitis Relapse: A Randomized Double-blind Controlled Multicentre Clinical Trial

Abstract

Atopic dermatitis (AD) affects adults and children and has a negative impact on quality of life. The present multicentre randomized double-blind controlled trial showed a barrier-improving cream (5% urea) to be superior to a reference cream in preventing eczema relapse in patients with AD (hazard ratio 0.634, p = 0.011). The risk of eczema relapse was reduced by 37% (95% confidence interval (95% CI) 10-55%). Median time to relapse in the test cream group and in the reference cream group was 22 days and 15 days, respectively (p = 0.013). At 6 months 26% of the patients in the test cream group were still eczema free, compared with 10% in the reference cream group. Thus, the barrier-improving cream significantly prolonged the eczema-free time compared with the reference cream and decreased the risk of eczema relapse. The test cream was well tolerated in patients with AD.

Clinical Effectiveness of Moisturizers in Atopic Dermatitis and Related Disorders: A Systematic Review

“…Four studies compared urea versus plain emollients (water-oil emulsions without urea or other 'active' substances): three in adults with AD [28,29,32] and one in patients with IV [30]. In 172 patients whose AD lesions had been cleared by means of corticosteroids, 6 months of treatment with urea 5 % significantly prolonged the time to relapse (HR 0.63, p = 0.011) [32].…”

“…In 172 patients whose AD lesions had been cleared by means of corticosteroids, 6 months of treatment with urea 5 % significantly prolonged the time to relapse (HR 0.63, p = 0.011) [32]. In the other two AD studies, urea 4 % was merely used as a positive control, and no formal comparison was made between urea and plain emollient [28,29].…”

“…Ten studies, all randomized controlled trials, investigated the clinical effectiveness of urea, in a total of 868 participants [17,19,23,[26][27][28][29][30][31][32]. In one of the studies, the risk of attrition bias was high as outcome data was incomplete for 13.3 % of the patients [23], but none of the remaining studies exhibited a high risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias.…”

The Effect of an Emollient Containing Urea, Ceramide NP, and Lactate on Skin Barrier Structure and Function in Older People with Dry Skin

“…Concentrations less than 10% were not tested in this particular study; however, formulations containing 5% urea have been shown to strengthen the skin barrier in a series of other studies [45,46]. Moreover the barrier-strengthening properties of the emollients were linked to the ability of the emollients to delay relapses of both AD and hand eczema in young adults [13,47,48,49]. The results of this study further demonstrate that a distinct 5% urea preparation with ceramide NP and lactate also imparts positive effects on skin barrier function and SC integrity in an older population.…”

Astragaloside IV ameliorates allergic inflammation by inhibiting key initiating factors in the initial stage of sensitization

“…They have reached epidemic proportions worldwide and their incidence is continuing to increase in association with modern lifestyles3. The mechanism underlying the recurrence of allergic diseases is far from resolved456, making it urgent to explore the mechanisms of allergic diseases and to develop new drugs that effectively reduce the rate of recurrence.…”