Centre of Evidence Based Dermatology
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Barrier Enhancement for Eczema Prevention (BEEP) feasibility study

Overview

The BEEP pilot was designed to see whether parents would be willing to take part in a trial involving applying emollients to their baby from birth to 6 months of age. The results of this pilot would then be used to help design a subsequent national trial to fully answer the question.

This trial was led by Chief Investigator Professor Hywel Williams and Senior Research Fellow Dr Joanne Chalmers at the Centre of Evidence Based Dermatology, University of Nottingham, and Dr Eric Simpson in Portland, USA.  

BEEP logo

 

Key facts

1. Why are you doing this study?

Eczema is a common skin problem that particularly affects young children. Whilst some people experience only mild symptoms, for others, their eczema can have a big impact on their life, with the misery of constant itching resulting in loss of sleep and time off school or work. We know that children with eczema also develop more food allergies, asthma and hayfever.

Since there is no known cure for eczema, finding a way to prevent it is particularly important.

 

2. What questions what the BEEP pilot trial designed to answer?

The main aim of the BEEP pilot trial was to assess whether parents were willing to take part in a trial of applying emollients to their baby from birth to 6 months of age.

All families were given advice on best practice skin care for their baby and half the families were advised to apply emollient at least daily to their baby until the age of 6 months. Babies were assessed by a dermatologist for signs of eczema at 6 months of age.

 

3. How many families took part?

A total of 124 families took part throughout the East Midlands, UK, and Portland, USA.

 
4. What were the main findings?

The BEEP pilot trial was very successful. It demonstrated that a large scale trial was possible and that the design of the trial was appropriate and acceptable to parents. The results also suggest that applying emollients to a baby’s skin from birth may be effective in preventing eczema.

Although this is an encouraging sign, this was a small pilot trial and so the results should be viewed with caution until the larger definitive trial is completed. This large BEEP trial (ISRCTN21528841) is now underway.

 

5. Why is this research important?

Since there is no known cure for eczema, finding a way to prevent it is particularly important. There are studies showing an association between loss-of-function filaggrin gene mutations and atopic eczema, and this has generated interest in the potential for enhancing the skin barrier to prevent the development of eczema.

It is known that emollients can reduce the incidence of flares of existing eczema and there is some evidence from uncontrolled studies that emollients may have a preventative effect against development of eczema. A definitive trial is needed but pilot work was needed before this could go ahead. The results of this pilot trial were used to support a successful bid to the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) for the main trial which will provide a definitive answer to whether emollients from birth can prevent eczema http://www.nets.nihr.ac.uk/projects/hta/126712.

 

6. How was the trial funded?

The BEEP pilot trial was funded as part of the NIHR Programme Grant RP-PG-0407-10177 “Setting Priorities and Reducing Uncertainties for the Prevention and Treatment of Skin Disease (SPRUSD)”PDF format.

 

Publications

Emollient enhancement of skin barrier from birth offers effective atopic dermatitis prevention [(Accepted for publication in The Journal of Allergy and Clinical Immunology (JACI)]

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

The Prevention of Eczema in Infants and Children: An Overview of Cochrane and Non-Cochrane reviews

Prevention of atopic dermatitis

Trial documents

Trial protocol PDF format

 

 

Acknowledgements

We would like to take this opportunity to thank everyone who has contributed to this trial (either as trial participants or as members of the research teams at each of the recruiting sites). Without the time you have given up and the enthusiasm you have provided, this study would not have been possible.

 

 

Centre of Evidence Based Dermatology

The University of Nottingham
King's Meadow Campus
Lenton Lane
Nottingham, NG7 2NR


telephone: +44 (0) 115 823 1048
email:cebd@nottingham.ac.uk