The Barrier Enhancement for Eczema Prevention (BEEP) Study
The BEEP study has shown that applying emollients to babies from birth does not prevent eczema. We looked at the skin of all the babies in the BEEP study when they reached two years of age and there was no difference in the number who had developed eczema between those who used emollients and those who didn’t.
Data from the BEEP trial will be incorporated into a prospective, individual patient data meta-analysis led by members of the BEEP team. This will include all similar ongoing studies and will provide more power to look at some of the secondary outcomes as well as a timely and high-quality meta-analysis of the primary outcome. Other related trials will be incorporated into a retrospective systematic review.
Many thanks to the 1394 families who are taking part in the BEEP study.
Without you this work would not have happened – you are part of ground-breaking research that has provided a clear answer to other families. As we are still following up all BEEP children up to the age of five, please do keep completing the questionnaires. These are really important to be able to look at any long term effects.
Why do the BEEP study?
Having eczema can have a big impact on people’s lives and because there is no cure, we wanted to look for a way to prevent eczema developing in children. We didn’t know whether moisturisers would be effective in preventing eczema, and the best way to find out was by doing this study.
The BEEP study was discussed in a BBC East Midlands Today feature on eczema. The BBC have kindly allowed us to share this:
How many families are involved in the BEEP study?
1394 newborn babies, born to families where a parent or sibling has/had asthma, eczema or hayfever are taking part in this study.
What were families asked to do?
Families entered the study around the time of the birth of the child. They were all given skincare advice, and those in the emollient group were advised to apply moisturisers at least once a day until their child reached their first birthday. Families kindly filled in questionnaires every 6-12 months and the study nurse carried out skin assessments when the children were 2 years old. The results of the study up to the age of 2 are now available.
Questionnaires are sent to the families when the children are 3, 4 and 5 years old – this is still ongoing.
Where is the study taking place?
The BEEP study is taking place in the following areas:
What were the results of the study?
701 babies were in the skincare advice group, and 693 babies were in the skincare advice plus moisturisers use group. The baseline characteristics were well similar across both groups
This trial did not show any differences between the two groups. The groups were the same in terms of:
- the numbers of children who went on to develop eczema,
- how early this eczema appeared
- how serious the eczema was
In the group that used daily moisturisers,
babies were slightly more at risk of
developing skin infections and had a slightly higher rate of food allergy.
What do the results mean for parents?
The BEEP study has shown that applying emollients from birth does not prevent eczema developing by the age of 2 in babies that are at a higher risk of developing eczema because someone in their family has or had eczema, asthma or hayfever.
Although the BEEP study showed that using emollients don’t work for preventing eczema, this is different from using emollients to treat eczema. Other studies have shown that emollients are a helpful part of treatment once a child has developed eczema.
Who is funding the study?
Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial. Lancet. 2020 Feb 19 doi:10.1016/S0140-6736(19)32984-8
An algorithm for diagnosing IgE‐mediated food allergy in study participants who do not undergo food challenge. Clin Exp Allergy. 2020 Jan 30. doi: 10.1111/cea.13577.
Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomised controlled trial. Trials. 2017 Jul 21;18(1):343. doi: 10.1186/s13063-017-2031-3.
Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. [BEEP pilot study] J Allergy Clin Immunol. 2014 Oct;134(4):818-23
How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies J Allergy Clin Immunol. 2012 Jul;130(1):137-44.
Prevention of atopic dermatitis F1000 Med Rep. 2012;4:24. doi: 10.3410/M4-24.
The Prevention of Eczema in Infants and Children: An Overview of Cochrane and Non-Cochrane reviews Evid Based Child Health. 2011 Sep;6(5):1322-1339.
Funding Acknowledgement This project is funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme (project number 12/67/12). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Health Technology Assessment programme, NIHR, NHS or the Department of Health.
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