Infant Atopic Dermatitis Treatment Reduces Food Allergy Risk

A recent study published in the Journal of Allergy and Clinical Immunology discovered that enhanced early skin treatment can substantially reduce the risk of developing food allergies in infants with atopic dermatitis (AD).

Researchers aimed to determine whether a proactive approach to treating both clinically affected and unaffected skin would be more effective in preventing hen's egg allergy than the conventional reactive treatment, which typically targets only clinically affected areas and utilizes topical corticosteroids (TCSs), in a multicenter, parallel-group, open-label, assessor-blind, randomized controlled trial focused on infants aged 7 to 13 weeks with AD.

Six hundred and fifty infants were enrolled in the study and randomly assigned to 1 of 2 groups: the enhanced early skin treatment group or the conventional reactive treatment group using TCSs. The primary outcome assessed was the proportion of immediate hen's egg allergy confirmed by oral food challenge at age 28 weeks.

Infants in the enhanced treatment group experienced a significant reduction in hen's egg allergy compared to those in the conventional treatment group (31.4% vs 41.9%, P = .0028). This represented a risk difference of -10.5%, with an upper bound of a 1-sided confidence interval of -3.0%. However, it is worth noting that the enhanced treatment did lead to lower body weight (mean difference: -422 g) and height (mean difference: -0.8 cm) at age 28 weeks.

“The enhanced treatment protocol of this trial should be modified before it can be considered as an approach to prevent hen’s egg allergy in daily practice to avoid the adverse effects of TCSs,” concluded the study authors. “After remission induction by TCSs, maintenance therapy with lower potency TCSs or other topical therapies might be considered as alternative proactive treatments to overcome the safety concerns of TCSs.”

Reference
Yamamoto-Hanada K, Kobayashi T, Mikami M, et al. Enhanced early skin treatment for atopic dermatitis in infants reduces food allergy. J Allergy Clin Immunol. 2023;152(1):126-135. doi:10.1016/j.jaci.2023.03.008