Evidence map›Paper›PMID 39021147›Full record

Trial reportHealth technology assessment (Winchester, England)2024

Emollient application from birth to prevent eczema in high-risk children: the BEEP RCT.

Lucy E Bradshaw, Laura A Wyatt, Sara J Brown, Rachel H Haines, Alan A Montgomery, Michael R Perkin, Tracey H Sach, Sandra Lawton, Carsten Flohr, Matthew J Ridd and 15 more

Abstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in Health technology assessment (Winchester, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. The age of eczema onset and multiple food allergies.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2026
    Article
  4. Novel approaches to prevent or cure allergic diseases.Current opinion in immunology · 2025
    Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Lucy E BradshawNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-8382-6040
Laura A WyattNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-9817-5356
Sara J BrownCentre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3232-5251
Rachel H HainesNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-7924-0602
Alan A MontgomeryNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-0450-1606
Michael R PerkinPopulation Health Research Institute, St George's, University of London, London, UK.ORCID 0000-0001-9272-2585
Tracey H SachHealth Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.ORCID 0000-0002-8098-9220
Sandra LawtonRotherham NHS Foundation Trust, Rotherham, UK.ORCID 0000-0002-6163-5822
Carsten FlohrUnit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK.ORCID 0000-0003-4884-6286
Matthew J RiddPopulation Health Sciences, University of Bristol, Bristol, UK.ORCID 0000-0002-7954-8823
Joanne R ChalmersCentre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-2281-7367
Joanne BrooksNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-2456-0160
Richard SwindenNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-9877-8301
Eleanor J MitchellNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-6998-4533
Stella TarrNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-8990-4425
Nicola JaySheffield Children's Hospital, Sheffield, UK.ORCID 0000-0003-1388-192X
Kim S ThomasUnit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK.ORCID 0000-0001-7785-7465
Hilary AllenNational Heart and Lung Institute, Imperial College London, London, UK.ORCID 0000-0002-7013-0308
Michael J CorkSheffield Dermatology Research, Department of Infection and Immunity, University of Sheffield, Sheffield, UK.ORCID 0000-0003-4428-2428
Maeve M KelleherNational Heart and Lung Institute, Imperial College London, London, UK.ORCID 0000-0002-3764-0461
Eric L SimpsonDepartment of Dermatology, Oregon Health & Science University, Portland, Oregon, USA.ORCID 0000-0003-0853-0252
Stella T LarteyHealth Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.ORCID 0000-0001-9519-7886
Susan Davies-JonesCentre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.
Robert J BoyleCentre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-4913-7580
Hywel C WilliamsCentre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-5646-3093

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Atopic eczema is a common childhood skin problem linked with asthma, food allergy and allergic rhinitis that impairs quality of life. Objectives: To determine whether advising parents to apply daily emollients in the first year can prevent eczema and/or other atopic diseases in high-risk children. Design: A United Kingdom, multicentre, pragmatic, two-arm, parallel-group randomised controlled prevention trial with follow-up to 5 years. Setting: Twelve secondary and four primary care centres. Participants: Healthy infants (at least 37 weeks' gestation) at high risk of developing eczema, screened and consented during the third trimester or post delivery. Interventions: Infants were randomised (1 : 1) within 21 days of birth to apply emollient (Doublebase Gel®; Dermal Laboratories Ltd, Hitchin, UK or Diprobase Cream®) daily to the whole body (excluding scalp) for the first year, plus standard skin-care advice (emollient group) or standard skin-care advice only (control group). Families were not blinded to allocation. Main outcome measures: Primary outcome was eczema diagnosis in the last year at age 2 years, as defined by the UK Working Party refinement of the Hanifin and Rajka diagnostic criteria, assessed by research nurses blinded to allocation. Secondary outcomes up to age 2 years included other eczema definitions, time to onset and severity of eczema, allergic rhinitis, wheezing, allergic sensitisation, food allergy, safety (skin infections and slippages) and cost-effectiveness. Results: One thousand three hundred and ninety-four newborns were randomised between November 2014 and November 2016; 693 emollient and 701 control. Adherence in the emollient group was 88% (466/532), 82% (427/519) and 74% (375/506) at 3, 6 and 12 months. At 2 years, eczema was present in 139/598 (23%) in the emollient group and 150/612 (25%) in controls (adjusted relative risk 0.95, 95% confidence interval 0.78 to 1.16; Limitations: Two emollient types were used which could have had different effects. The median time for starting emollients was 11 days after birth. Some contamination occurred in the control group (< 20%). Participating families were unblinded and reported on some outcomes. Conclusions: We found no evidence that daily emollient during the first year of life prevents eczema in high-risk children. Emollient use was associated with a higher risk of skin infections and a possible increase in food allergy. Emollient use is unlikely to be considered cost-effective in this context. Future research: To pool similar studies in an individual patient data meta-analysis. Trial registration: This trial is registered as ISRCTN21528841. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 12/67/12) and is published in full in

Indexed as

Cost-Benefit AnalysisEczemaEmollientsChild, PreschoolDermatitis, AtopicFemaleHumansInfantInfant, NewbornMaleQuality-Adjusted Life YearsQuality of LifeTechnology Assessment, BiomedicalUnited KingdomEmollientsASTHMAATOPIC DERMATITISATOPIC ECZEMAECZEMAEMOLLIENTSFILAGGRINFOOD ALLERGYHAY FEVERINFLAMMATIONMOISTURISERSPREVENTIONRANDOMISED CONTROLLED TRIALSKIN BARRIERSKIN SENSITISATION

Identifiers

PMID39021147
PMCPMC11261424

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.