This review forms part of a series of annual updates that summarize the evidence base for
atopic eczema (AE). It provides a summary of key findings from 25 systematic reviews that were published or indexed during 2017, and focuses on the treatment and prevention of AE. There is high-quality evidence to demonstrate that
dupilumab is better than placebo for the treatment of AE, is not associated with a higher incidence of adverse effects and does not increase the risk of
infection compared with placebo; however, comparison studies with other systemic treatments are necessary. Topical
tofacitinib is a promising treatment for mild-moderate AE, but currently lacks sufficient evidence from well-designed randomized controlled trials (RCTs) comparing with other active treatments. Topical
doxepin may be effective for
pruritus in AE, but available studies have short follow-up periods and longer-term outcomes are needed. Bleach
baths were no more effective than water
baths alone at reducing AE severity. Topical
antibiotics cannot be recommended for infected AE, owing to insufficient evidence of benefit. There is little comparison of different
emollients in RCTs, but overall evidence indicates that they reduce AE severity, are
steroid-sparing and lead to better outcomes in combination with topical
corticosteroids (TCS) than TCS alone. No clear benefit was demonstrated for
vitamin D/C/E supplementation in pregnancy for
eczema prevention.