A related editorial notes that emollient bath additives are commonly prescribed, costing the English NHS more than £17m a year in primary care alone.
GP practices participating in the study were encouraged to issue one of the three most commonly prescribed emollient bath additives (Oilatum; Balneum; Aveeno) but others could be issued as long as they did not contain antimicrobials. The trial was not powered to compare the efficacy of different products, but they would be expected to have similar results as they all have a similar mode of action.
The results of a subgroup analysis are highlighted – a significant improvement in mean POEM score was seen in children below 5 years. However the upper limit of the confidence interval of the difference versus no emollient use (2.25 points) is less than the minimal clinically important difference (3 points). The editorial says that this “leaves open the question of whether younger children might still benefit from bath emollients, especially infants who are often bathed daily but were excluded from this trial.” They comment that although there is “still some room for further work….an important evidence gap has been closed. Both the NHS and families of children with eczema can now better invest in more effective treatments for this common and distressing condition.”