title: An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a prevalent skin disorder with significant cost of treatment. Several prescription device moisturizers have been approved by the FDA to treat AD but are significantly more expensive than well-crafted over-the-counter (OTC) moisturizers. No studies have been performed to compare both the clinical efficacy and cost-efficacy of these prescription devices to OTC moisturizers.
  
  
  OBJECTIVE
  The purpose of this study is to compare the clinical efficacy and cost-efficacy of a glycyrrhetinic acid-containing barrier repair cream (BRC-Gly, Atopiclair®), a ceramide-dominant barrier repair cream (BRC-Cer, EpiCeram®) and an OTC petroleum-based skin protectant moisturizer (OTC-Pet, Aquaphor Healing Ointment®) as monotherapy for mild-to-moderate AD in children.
  
  
  METHODS
  Thirty-nine patients, age 2-17 years, with mild-to-moderate AD were randomized 1:1:1 to receive one of three treatments-BRC-Gly, BRC-Cer or OTC-Pet-with instructions to apply the treatment three times daily for three weeks. Disease severity and improvement was assessed at baseline and on days 7 and 21.
  
  
  RESULTS
  No statistically significant difference for any efficacy assessment was found between the three groups at each time point. The OTC-Pet was found to be at least 47 times more cost-effective than BRC-Gly or BRC-Cer.
  
  
  CONCLUSIONS
  The relatively small sample size of 39 subjects was not sufficient to establish OTC-Pet as superior treatment in AD.
  
  
  CONCLUSIONS
  OTC-Pet is as effective in treating mild-to-moderate AD as both BRC-Gly and BRC-Cer and is at least 47 times more cost-effective.
  II-AF-ATD-Aquaphor, Comparing the Efficacy and Cost-Effectiveness of Aquaphor to Atopiclair and EpiCeram in Children with Mild to Moderate Atopic Dermatitis. REGISTRATION IDENTIFIER: NCT01093469.
authors.affiliation: Department of Dermatology,Wake Forest University School of Medicine,Winston-Salem, NC 27104, USA.
authors.forename: Drew W
authors.initials: DW
authors.lastname: Miller
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Koch
authors.forename: Brad A
authors.initials: BA
authors.lastname: Yentzer
authors.forename: Adele R
authors.initials: AR
authors.lastname: Clark
authors.forename: Jenna R
authors.initials: JR
authors.lastname: O'Neill
authors.forename: Julie
authors.initials: J
authors.lastname: Fountain
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Weber
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D002518:Ceramides / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000473:pathology; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D004041:Dietary Fats / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D004643:Emollients / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D005227:Fatty Acids / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006034:Glycyrrhetinic Acid / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D010577:Petrolatum / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D010936:Plant Extracts / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D055553:Prescription Drugs / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D002518:Ceramides; D003879:Dermatologic Agents; D004041:Dietary Fats; D004338:Drug Combinations; D004643:Emollients; C539259:EpiCeram; D005227:Fatty Acids; C530270:MAS063DP; D004366:Nonprescription Drugs; D010936:Plant Extracts; D055553:Prescription Drugs; D010577:Petrolatum; D002784:Cholesterol; D006034:Glycyrrhetinic Acid