Trial | Duration (wk)a | Baseline AD severity | Age, mean (range) | TCS Potency [87] | N | Treatmentb |
---|---|---|---|---|---|---|
Controlled studies | ||||||
Thomas 2002 [70] | 18 | mild to moderate (mean SASSAD = ~8–14) | 5 yr (1–15) | low (class 7–6) | 104 | hydrocortisone ointment 1 % BID (DB) for 7 d bursts “when required” |
mild to moderate (mean SASSAD = ~9–16) | 6 yr (1–15) | mid (class 5–3) | 103 | alternating (DB) betamethasone valerate ointment 0.1 % BID (3 d) and emollient BID (4 d) for 7 d bursts “when required” | ||
Jorizzo 1995 [71] | 25 | mild to moderate | 5 yr (<1–12) | low (class 7–6) | 16 | desonide ointment 0.05 % BID (SB) |
low (class 7–6) | 20 | hydrocortisone ointment 1 % BID (SB) | ||||
Hanifin 2002 [72] | 44 | moderate to severe (mean R&L = 7) | 7 yr (<1–17) | mid (class 5–3) | 154 | fluticasone propionate cream 0.05 % BID (OL) for ≤4 wks until clearance; then fluticasone propionate BID (DB) decreased over 20 wk to QD 2x/wk; then fluticasone propionate QD 2x/wk (OL) for 20 wk |
- | 77 | fluticasone propionate cream 0.05 % BID (OL) for ≤4 wks until clearance; then vehicle BID (DB) decreased over 20 wk to QD 2x/wk; then fluticasone propionate QD 2x/wk (OL) for 20 wk | ||||
Meta-analysis | ||||||
Kirkup 2003 [73]c | 16 | moderate to severe (mean ADd = ~12e) | 8 yr (2–14) | mid (class 5–3) | 136 | hydrocortisone 1 % cream BID for 1–2 wk, then fluticasone propionate cream 0.05 % BID (DB) for 2–4 wk and then “as required” for flares |
low or mid (class 7–3) | 129 | hydrocortisone 1 % cream BID for 1–2 wk, then hydrocortisone 1 % or hydrocortisone butyrate 0.1 % BID (DB) for 2–4 wk and then “as required” for flares | ||||
TCS as active comparatorf | ||||||
Hofman 2006 [50] | 28 | moderate to severe (≥4.5 R&L) | ~6 yr (2–11) | - | 133 | tacrolimus 0.03 % BID for 3 wk, then tacrolimus QD + vehicle QD (DB) for flares |
low (class 7–6) | 124 | hydrocortisone ointment 1 % BID for head/neck and hydrocortisone butyrate ointment 0.1 % BID for trunk/limbs for 2 wk, then hydrocortisone 1 % BID (DB) for flares | ||||
- | 50 | no treatment (patients did not have AD) | ||||
Sigurgeirsson 2015 [61] | 260 | mild to moderate (IGA = 2–3) | 7 mo (3–12) | - | 1205 | pimecrolimus 1 % (OL) until clearance, and then as needed for flaresg |
mild to moderate (IGA = 2–3) | 7 mo (3–12) | low or mid (class 7–3) | 1213 | hydrocortisone 1 % or hydrocortisone butyrate 0.1 %(OL) until clearance, and then as needed for flaresg |