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. 2022 Nov 14;2022(11):CD013534. doi: 10.1002/14651858.CD013534.pub3

Horimukai 2014.

Study characteristics
Methods Study design: randomised controlled, parallel‐group, investigator‐blinded trial
Recruitment date: November 2010 to November 2013
Treatment arms: 2
AD follow‐up: 4 weeks, 12 weeks, 24 weeks, 32 weeks
FA follow‐up: sensitisation to food and inhalants at 32 weeks 
Participants Randomised: N = 118 (intervention n = 59; control n = 59)
Inclusion criteria: 
  1. Infant within the first week after birth

  2. High‐risk infant from atopic dermatitis (family history)

  3. Infant without treatment with corticosteroids

  4. Infant whose parents gave informed consent


Exclusion criteria: 
  1. Infant treated with corticosteroid ointment (except genital and anal areas)

  2. Infant with skin lesions such as dyskeratosis or bullosa diagnosed by specialists in dermatology

  3. Small‐for‐gestational‐age (< 37 weeks)

  4. Infant with hepatic disease, convulsion, cardiac disease, haemophilia, diabetes, or autoimmune disease

  5. Inappropriate case as evaluated by doctors

Interventions Intervention: emollient was applied each day for 32 weeks. Hanifin‐Rajka criteria were used to diagnose AD.
Comparator: control group applied petroleum jelly if desired
Moisturiser/emollient: emulsion‐type emollient (2e (Douhet) emulsion) from the first week of life; petroleum jelly was prescribed to each infant in both groups on request by the institutional review board
Outcomes Primary outcomes: the cumulative rate of incidence of AD, eczema, or both by temporal observation. Modified UKWP criteria were applied by a dermatology specialist.
Secondary outcomes: 
  1. Specific IgE antibodies

  2. TEWL

  3. Stratum corneum water concentration

  4. Stratum corneum pH

  5. Staphylococcus aureus on skin

  6. Onset of allergic disease such as asthma and food allergy


Adverse events: “the dermatology specialist stopped giving the emollient to 3 infants whose skin lesions seemed to be the result of urticaria or contact dermatitis caused by emulsion‐type emollients (related adverse events). After several days, however, the doctor judged that these skin lesions were not adverse events because they disappeared rapidly, and similar lesions were not seen when the same emollients were used again. These 3 infants did not have AD/eczema or skin rash when they were followed for 32 weeks. There were no infants from families that withdrew consent who had skin lesions. In summary, adverse events caused by this emulsion‐type emollient were not observed during this RCT”
No IPD are available on adverse events.
Identification Sponsorship source: supported in part by Health and Labour Sciences Research Grants for Research on Allergic Diseases and Immunology from the Ministry of Health, Labour and Welfare of Japan (H22‐Men'eki‐Ippan‐002 to HS; H25‐Nanchito‐Ippan‐001 to MA and HS as principal investigators) and grants from the National Center for Child Health and Development (20S‐1 to YO and 23S‐3 to HS)
Country: Japan
Setting: National Center for Child Health and Development, the only national hospital for mothers and children in Tokyo
Declarations of interest Extensive list in the trial publication
Notes