Daily emollient use may prevent atopic dermatitis among high-risk infants
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SAN ANTONIO — Daily use of an emollient may reduce the risk for atopic dermatitis among infants with loss-of-function filaggrin mutations, according to data presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
“Knowing this genetic risk factor, we wanted to examine if using this treatment at the start of life could make a difference on the future development of atopic dermatitis,” Jonathan O’B. Hourihane, MD, FAAAAI, professor of pediatrics at Royal College of Surgeons in Ireland, said in a press release.
Researchers evaluated data of 257 infants of parents with allergic disease enrolled in the STOP-AD trial who had complete genotyping information. Of them, researchers randomly assigned 119 into an intervention group and 138 into a control group. The infants in the intervention group received daily doses of Aveeno Dermexa Fast & Long-Lasting Balm (Johnson & Johnson) from the first 4 postnatal days through 8 weeks.
At 12 months, the cumulative incidence of AD included 46% of the infants in the control group and 33% of those in the intervention group (P = .03).
Also, 17.4% of the total cohort carried the loss-of-function filaggrin (LOF-FLG) mutation, which the researchers called the strongest genetic risk factor for AD.
Among infants in the control group, those with LOF-FLG showed significantly higher AD prevalence than those with wild-type FLG (WT-WLG) at 6 months (56% vs. 32%; P = .02) and 12 months (59% vs. 34%; P = .01).
However, in the intervention group, the AD rates of the LOF-FLG and WT-FLG infants were similar at both 6 (19% vs. 15%) and 12 months (14% for both).
“We did not know the children’s genotype until after the study finished,” Hourihane said.
“Being able to prospectively ascertain a child’s FLG status at birth could allow targeted, time-sensitive treatments just for those most at risk and conversely prevent other children at lower risk from entering trials or having unnecessary treatment,” he continued.
Based on these findings, the researchers concluded that daily, specialized emollients during the first 2 months of life could reduce the likelihood of developing AD for infants with LOF-FLG. Also, the researchers said, genetic testing could help providers determine which infants would benefit most from this intervention.