Helping to design the Rapid Eczema Trials Keep Control study

We recently ran a survey looking at how people with eczema use topical corticosteroid creams to treat flare-ups. We also asked for people’s views on a study testing different ways of using steroid creams. We are using the results from this survey to plan a clinical study looking at how best to keep control of eczema.

Here are the main results:

We received 136 survey responses. These were from adults (115), parents of children with eczema (18), and carers of adults with eczema (3). Most of the people who answered were women (74%). Most of the people with eczema were between 36 and 59 years old (35%), or over 60 years old (31%). Most described their eczema as ‘bad’ (38%) or ‘ok’ (34%).

These results gave us some useful messages to consider when planning the study.

Everyone uses steroid creams differently

Most people (39%) start using steroid creams as soon as a flare-up begins. Others (31%) wait a few days to see how bad the flare-up is before starting to use steroid creams. Others (26%) only use steroid creams when the flare-up is really bad. There are also differences in when people stop using steroid creams. Most people stop either ‘when the skin looks normal again’ (33%) or ‘when the itchiness improves’ (33%). Some people (22%) stop using steroid creams ‘a day or two after the skin looks normal again’.

Most people follow advice from healthcare professionals on how to use steroid creams. The most common advice is ‘apply a thin layer’ and ‘use sparingly’. Other common advice is ‘use as needed’ and ‘use until the eczema improves’.

These results help us understand how people are currently using steroid creams. This is important for us to consider when we are designing the study. The results will also help us develop the guidance that we give to people who take part in the study.

Some people have more flare-ups than others

When asked how often they have eczema flare-ups, some people (35%) said ‘all of the time’. A similar number (35%) said ‘at least once a month’. Slightly fewer (23%) said every few months. A few individuals said ‘once or twice a year’. This information is important to help us work out how many months people need to be in the study. It also helps us make decisions about how frequent someone’s flare-ups need to be for them to take part in the study.

People would join the study

The type of study we are designing is called a ‘randomised controlled trial’. There will be two groups of people, each asked to use steroid creams in a different way during a flare-up. Participants cannot choose their group. For this study, one group will use their steroid cream as they would do normally during a flare-up. The other group will use their steroid cream during a flare-up and for two days after the skin looks and feels eczema free.

Based on the survey results, it looks as though enough people (roughly half) would be willing to join either group.

Designing the study

Some people who join the study might have eczema on more than one body area. We wanted to know how these people would prefer to treat the different areas. For example, would they want to treat all areas of eczema the same? Or, would they want to treat some areas in the way that is normal for them, and others in the way that the study advises? We asked this question in the survey. Around 51% of respondents would prefer to follow the study guidelines to treat all of their eczema. A smaller number (32%) would prefer to only treat one area of eczema according to the study guidelines.

If taking part in the study, 63% of respondents said they would stay in the study for as long as needed. Around 18% would do it for less than 2 months, and 14% would do it for 3 or 4 months. Based on these results, we have decided to run the study for four months.

This information has helped us finalise the study question. We will ask:

‘Does treating eczema flare-ups for slightly longer help people keep control for longer?’

It will also help us design the study and develop the guidance that we provide to participants.

Thank you for sharing your experiences with us to help move this research forwards.