Performance and Tolerability of the Moisturizers Cetaphil® and Excipial® in Atopic Dermatitis: What is the Evidence Based on Randomized Trials?

Abstract

IntroductionMoisturizers play a prominent role in the management of atopic dermatitis by improving the impaired skin barrier function and enhancing skin hydration. Their efficacy was evaluated in a recently published Cochrane Review ‘Emollients and moisturizers for eczema’.ObjectiveIn the present review, we summarize the performance and safety of Cetaphil® and Excipial® moisturizing products.MethodsThis review was carried out in compliance with standard Cochrane methodological procedures, which means independent study selection, data extraction, assessment of risk of bias, and analyses by two review authors. The quality of evidence for the predefined outcomes was rated with the GRADE approach. The prespecified outcomes of the review included participant assessments, satisfaction, adverse events, investigator assessments, prevention of flares, change in use of topical active treatment, skin barrier function and quality of life.ResultsFour randomized controlled studies examining these moisturizers were included in the previously published Cochrane Review. For the performance and tolerability of these moisturizers, there was very low to moderate quality evidence for the prespecified outcomes.ConclusionThe results from these four studies are in line with those of the Cochrane Review that moisturizers themselves have beneficial effects, and that combining moisturizers with active topical treatment produced better results when compared to active topical treatment alone.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-017-0184-3) contains supplementary material, which is available to authorized users.

Clinical Insights About Topical Treatment of Mild-to-Moderate Pediatric and Adult Atopic Dermatitis

“…Moisturizers remain the cornerstone of treatment for all severities of AD to counter and control the xerosis, decrease epidermal water loss, and improve the dysfunctional epidermal barrier. 14 A Cochrane review 36 with a focus on moisturizers that contained humectants, lipids, and/or ceramides (or their precursors) 37 reported their daily use reduced the rate of flares and enhanced the efficacy of topical steroid treatment. The panel agreed with established guidelines 14-20,23 supporting the daily use of moisturizers, alone or in combination with other therapy, for all AD patients to prevent itching, reduce flare frequency, and restore the lipid balance of the skin.…”

Pilot Studies on Two Complementary Bath Products for Atopic Dermatitis Children: Pine-Tar and Tea

“…Reports on proprietary emollients commonly described their efficacy and adverse effects profiles in AD treatment [3,8,46,47]. Very few studies have reported on patient’s acceptability or satisfaction of the trial emollient [6,48].…”

Emollient treatment of atopic dermatitis: latest evidence and clinical considerations

“…A number of proprietary emollients have undergone trials with clinical data reported in PubMed-indexed journals. Most moisturizers showed some beneficial effects, but there was generally no evidence that one moisturizer is better than the other [ 3 , 60 ]. Choosing an appropriate emollient for AD patients would improve acceptability and adherence for emollient treatment.…”

“…As reported by van Zuuren and colleagues in 2017, the mean duration of clinical studies on emollients (n=77) was 6.7 weeks and mean age of patients 18.6 years [ 3 , 60 ]. The clinical studies ranged from comparing studied product with vehicle or no treatment.…”

“…However, the authors found no evidence that one moisturizer is better than the other [ 3 ]. Moisturizers themselves were found to have beneficial effects, and combining moisturizers with active topical treatment produced better results when compared to active topical treatment alone [ 60 ].…”