The aim of this pragmatic, parallel group, assessor-blind randomised open-label prospective study is to determine the reasons that motivate parents to enrol or not enrol their child in a randomized, controlled basic emollient trial for the prevention of atopic eczema (AE). Furthermore, this trial intends to test the hypothesis that daily skin barrier enhancement with Lipikar Baume AP+® in newborns at high risk is safe and efficient in preventing AE. T
The aim of this trial is to determine the reasons that motivate parents to enrol or not enrol their child in a randomized, controlled basic emollient trial for the prevention of AE. Furthermore, this trial intends to test the hypothesis that daily skin barrier enhancement with Lipikar Baume AP+® in babies at high risk of allergic disease is safe and to estimate the preventive effectiveness of Lipikar Baume AP+® in the prevention of AE in a high risk population. Objectives: The primary objectives are to investigate the 1. Feasibility: 1. Parental willingness to enter a child in a controlled primary prevention trial 2. Compliance with intervention 2. Safety: incidence of skin-related adverse events and serious adverse events during the study 3. Effectiveness: 1. Cumulative incidence of AE within 2 years after randomization. 2. Age of onset of AE Study design: Pragmatic, parallel group, assessor-blind randomised open-label prospective study of emollient use in 50 high-risk neonates starting between days 1 and 21. Child participation in the main part of the trial will be 2 years (from within 3 weeks of birth until approximately the child's second birthday). This will comprise a 1 year intervention phase then the primary outcome is assessed at 2 years. Participants: Participants will be newborn babies at high risk of developing AE defined as a parent or sibling who has (or had) doctor diagnosed asthma, AE or allergic rhinitis. Intervention: The intervention is daily application of emollient to the baby's entire body surface area including the face for the first year of life. Intervention and control group will receive structured parent education that comprises general advice on best practice skin care for their baby in line with the German AWMF S3 guidelines for allergy prevention and the Federal Centre for Health Education. Data collection: Infants will be examined at scheduled visits at Months 1, 6, 12, and 24. Telephone visits were performed at months 3 and 18 to assess for side effects, rashes, and compliance. Daily parental recordings will be assessed using electronic data capturing tools. Primary Outcomes: The primary outcomes will be feasibility, safety and tolerability, and preventive effectiveness.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
50
Structured education on prevention guidelines
USchleswig-Holstein
Kiel, Scheswig-Holstein, Germany
Willingness to participate
Willingness of parents to get their child randomized and to adhere to the regimen
Time frame: 2 years
Development of AE
Cumulative incidence of AE
Time frame: 2 years
Transepidermal water loss
Development of transepidermal water loss over time
Time frame: 2 years
Microbiome diversity
Development of microbiome diversity over time
Time frame: 2 years
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