HealthCert Blog

This review, which is part of a series of annual updates on the evidence base for atopic eczema, highlighted key findings from 12 systematic reviews from 2014 focusing on treatment and prevention. It shows the difficulty in effectively treating atopic eczema. Although cyclosporin, azathioprine and methotrexate are commonly used to treat atopic eczema, evidence supporting their relative efficacy is limited. There was insufficient evidence to support the use of vitamin D supplements, alpine climate treatment or probiotics for the treatment of atopic eczema. Sublingual immunotherapy for patients with atopic eczema and aeroallergen sensitivity may be beneficial, but requires further evaluation and is not commonly available. The use of probiotics prenatally and continued postnatally may help prevent atopic eczema.

There is currently no evidence for the role of allergen avoidance in the prevention of atopic eczema. The treatment options for severe atopic eczema still remain limited, with cyclosporin the best option based on current data, but its long-term use is limited by its side effects. There is some evidence to support educational interventions, phototherapy and topical sodium cromoglycate cutaneous emulsion. There are newer treatment options being studied, including IL-4 and IL-13 inhibitors and phosphodiesterase inhibitors, so the space may change in the future.