Atopic dermatitis (eczema) in infants is a strong risk factor for developing food allergies. Researchers looked at whether enhanced, proactive treatment rather than reactive treatment would help prevent the sensitization to foods.
In this study, published in the Journal of Allergy and Clinical Immunology, they tested whether an enhanced protocol of treatment for eczema in both clinically affected and unaffected skin is more effective at preventing hen’s egg allergy than reactive treatment alone.
The study — Prevention of Allergy via Cutaneous Intervention (PACI) — enrolled 650 infants aged 7-13 weeks with atopic dermatitis and randomly assigned them to two groups: one to receive enhanced early skin treatment, the other to receive reactive treatment, using topical corticosteroids. They then conducted oral food challenges to eggs at 28 weeks of age.
640 of the 650 participants were analyzed at the endpoint, with 318 receiving enhanced treatment and 322 receiving conventional treatment.
The researchers determined that enhanced treatment significantly reduced hen’s egg allergy compared with those receiving conventional treatment: 31.4% vs 41.9%. They did observe adverse effects: a decrease in body weight (422g mean) and height (0.8cm mean) were observed in the enhanced group at 28 weeks of age
The researchers highlighted the potential of well-controlled atopic dermatitis management as a component of a hen’s egg allergy prevention strategy. They said the enhanced treatment protocol of the trial should be modified before it can be considered as an approach to prevent hen’s egg allergy in daily practice in order to avoid the adverse effects of TCSs. They suggest that after remission induction, the maintenance therapy should use lower potency TCSs or other topical therapies.