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

摘要

Objective To determine whether a three day burst of\uda potent corticosteroid is more effective than a mild\udpreparation used for seven days in children with mild\udor moderate atopic eczema.\udDesign Randomised, double blind, parallel group\udstudy of 18 weeks' duration.\udSetting 13 general practices and a teaching hospital\udin the Nottingham area.\udParticipants 174 children with mild or moderate\udatopic eczema recruited from general practices and\ud33 from a hospital outpatient clinic.\udInterventions 0.1% betamethasone valerate applied\udfor three days followed by the base ointment for four\uddays versus 1% hydrocortisone applied for seven days.\udMain outcome measures Primary outcomes were\udtotal number of scratch­free days and number of\udrelapses. Secondary outcomes were median duration\udof relapses, number of undisturbed nights, disease\udseverity (six area, six sign atopic dermatitis severity\udscale), scores on two quality of life measures\ud(children's life quality index and dermatitis family\udimpact questionnaire), and number of patients in\udwhom treatment failed in each arm.\udResults No differences were found between the two\udgroups. This was consistent for all outcomes. The\udmedian number of scratch­free days was 118.0 for the\udmild group and 117.5 for the potent group (difference\ud0.5, 95% confidence interval - 2.0 to 4.0, P = 0.53).\udThe median number of relapses for both groups was\ud1.0. Both groups showed clinically important\udimprovements in disease severity and quality of life\udcompared with baseline.\udConclusion A short burst of a potent topical\udcorticosteroid is just as effective as prolonged use of a\udmilder preparation for controlling mild or moderate\udatopic eczema in children.