Effectiveness of Potent Topical Corticosteroids for Children with Atopic Dermatitis
Study Overview
This study evaluated how effective a strong topical corticosteroid (TCS) is compared to a mild one for treating moderate flare-ups of atopic dermatitis (AD) in children. The research was conducted in primary care settings.
Study Details
- Design: Observational cohort study with a randomized controlled trial.
- Location: 53 general practices in the southwest Netherlands.
- Participants: 209 children aged 3 months to 17 years diagnosed with AD, with 32 patients randomized for the trial.
Treatment Groups
Children experiencing moderate flare-ups were assigned to one of two groups:
- Intervention Group: Strong TCS (fluticasone propionate 0.05%).
- Control Group: Mild TCS (hydrocortisone acetate 1%).
Outcome Measures
Results were measured at the start of the trial and at 1, 4, and 24 weeks. Key outcomes included:
- AD-related symptoms (Patient-Oriented Eczema Measure – POEM).
- Quality of life (QoL) assessments.
Key Findings
- Significant improvement in POEM scores for the strong TCS group (3.3) compared to the mild TCS group (9.4) over 24 weeks (p=0.023).
- Improvement in QoL was also significant at 4 weeks (1.0 vs 4.5, p=0.014) and 24 weeks (0.0 vs 2.0, p=<0.000).
Conclusion
The study suggests that starting treatment with a potent TCS is more beneficial than a mild TCS for moderate flare-ups of AD in children, despite the small sample size.
Clinical Implications
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