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Purpose: Environmental factors such as bathing may play a role in atopic dermatitis (AD) development. This analysis utilized data from the Community Assessment of Skin Care, Allergies, and Eczema (CASCADE) Trial (NCT03409367), a randomized controlled trial of emollient therapy for AD prevention in the general population, to estimate bathing frequency and associated factors within the first 9 weeks of life. Methods: Data were collected from 909 parent/newborn dyads recruited from 25 pediatric and family medicine clinics from the Meta‐network Learning and Research Center (Meta‐LARC) practice‐based research network (PBRN) consortium in Oregon, North Carolina, Colorado, and Wisconsin for the CASCADE trial. Ordinal logistic regression was used to conduct a cross‐sectional analysis of the association between bathing frequency (measured in baths per week) and demographic, medical, and lifestyle information about the infant, their family, and their household. Variables were selected using a backwards‐stepwise method and estimates from the reduced model are reported in the text. Results: Moisturizer use (OR = 2.03, 95% CI: 1.54–2.68), Hispanic or Latino ethnicity (OR = 1.97, 95% CI: 1.42–2.72), a parental education level lower than a 4‐year college degree (OR = 2.48, 95% CI: 1.70–3.62), living in North Carolina or Wisconsin (compared to Oregon; OR = 2.12 and 1.47, 95% CI: 1.53–2.93 and 1.04–2.08, respectively), and increasing child age (in days; OR = 1.02, 95% CI: 1.01–1.02) were significantly associated with more frequent bathing, while pet ownership (OR = 0.67, 95% CI: 0.52–0.87) was significantly associated with less frequent bathing. Conclusions: We found significant ethnic, geographic, and socioeconomic variation in bathing frequency before 9 weeks of age that may be of relevance to AD prevention studies. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a common, chronic skin disorder often beginning in infancy. Skin barrier dysfunction early in life serves as a central event in the pathogenesis of AD. In infants at high risk of developing AD, preventative application of lipid-rich emollients may reduce the risk of developing AD. This study aims to measure the effectiveness of this intervention in a population not selected for risk via a pragmatic, randomized, physician-blinded trial in the primary care setting.Methods: Infant-parent dyads are recruited from a primary care practice participating through one of four practice-based research networks in Oregon, Colorado, Wisconsin, and North Carolina. Eligible dyads are randomized to the intervention (daily use of lipid-rich emollient) or the control (no emollient) group (n = 625 infants in each) and are followed for 24 months. The primary outcome is the cumulative incidence of physician-diagnosed AD and secondary outcomes include caregiver-reported measures of AD and development of other atopic diseases. Data collection occurs via chart review and surveys, with no study visits required. Data will be analyzed utilizing intention-to-treat principles.Discussion: AD is a common skin condition in infants that affects quality of life and is associated with the development of other atopic diseases. If a safe intervention, such as application of lipid-rich emollients, in the general population effectively decreases AD prevalence, this could alter the guidance given by providers regarding routine skin care of infants. Because of the pragmatic design, we anticipate that this trial will yield generalizable results.Trial Registration: ClinicalTrials.gov: NCT03409367. Registered on 11 February 2018. [ABSTRACT FROM AUTHOR]

Introduction: As new topical and systemic treatments become available for atopic dermatitis (AD), there is a need to understand how treatments are being used in routine clinical practice, their comparative effectiveness and their long-term safety in diverse clinical settings., Methods and Analysis: The TARGET-DERM AD cohort is a longitudinal, observational study of patients with AD of all ages, designed to provide practical information on long-term effectiveness and safety unobtainable in traditional registration trials. Patients with physician-diagnosed AD receiving prescription treatment (topical or systemic) will be enrolled at academic and community clinical centres. Up to 3 years of retrospective medical records, 5 years of prospective medical records, and optional biological samples and patient-reported outcomes will be collected. The primary aims include characterisation of AD treatment regimens, evaluation of response to therapy, and description of adverse events., Ethics and Dissemination: TARGET-DERM has been approved by a central IRB (Copernicus Group IRB, 5000 Centregreen Way Suite 200, Cary, North Carolina 27513) as well as local and institutional IRBs. No additional Ethics Committee reviews. Results will be reviewed by a publications committee and submitted to peer-reviewed journals., Trial Registration Number: NCT03661866, pre-results., Competing Interests: Competing interests: KA: receives compensation for consulting services from TARGET PharmaSolutions; no other competing interests. JIS: AbbVie, Anaptysbio, Arena, Asana, Boehringer-Ingelheim, Dermira, Dermavant, DS Biopharma, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Incyte, Kiniksa, LEO Pharma, Luna, Menlo, Novartis, Pfizer, Regeneron Pharmaceuticals, Sanofi – consultant or advisory board member; Regeneron Pharmaceuticals, Sanofi – speaker. ELS: grants and personal fees from AbbVie, grants and personal fees from Eli Lilly, grants from Galderma, grants from Kyowa Hakko Kirin, grants and personal fees from Leo Pharmaceutical, grants from Merck, grants and personal fees from Pfizer, grants and personal fees from Regeneron, personal fees from Sanofi, personal fees from Dermira, grants from Galderma, grants and personal fees from MedImmune, grants from Novartis, grants from Tioga, grants from Celgene, personal fees from Boehringer-Ingelheim, personal fees from Dermavant, personal fees from Forte Bio, personal fees from Incyte, personal fees from Menlo Therapeutics, personal fees from Ortho Dermatologics, personal fees from Pierre Fabre Dermo Cosmetique, personal fees from Valeant. ASP: investigator for AbbVie, Anaptysbio, Celgene, Eli Lilly, Galderma, Incyte, Leo, Janssen, Novartis, and Regeneron; consultant with honorarium for Almirall, Amgen, Asana, Boehringer-Ingelheim, Castle Creek, Celgene, Dermavant, Dermira, Eli Lilly, Exicure, Forte, Galderma, Lenus, Leo, MEDA Corp, Meiji Seika, Novan, Novartis, Pfizer, Regeneron, Sanofi-Genzyme, and Sol Gel. LE: Consultant/Speaker/Advisory Board: Almirall, Dermavant, Dermira, DS Biopharma, Forte, Galderma, Incyte, LEO, Lilly, L’Oreal, Matrisys, Otsuka, Novartis, Ortho Dermatologics/Valeant, Pfizer/Anacor, Regeneron, Sanofi-Genzyme. Investigator: Abvie, LEO, Regeneron, Sanofi-Genzyme. DSM: Asana, Ichnos/Glenmark. RB: Advisory Board Member, Consultant, Speaker, Investigator for and/or receives honoraria or grant from AbbVie, AntibioTx, Arcutis, Arena Pharma, Asana BioSciences, Bellus Health, Boehringer-Ingelheim, Dermavant, Eli Lilly, EMD Serono, Galderma, Incyte, Kiniksa, Kyowa Kirin, Neokera, LEO Pharma, Novan, Pfizer, Ralexar, RAPT, Regeneron, Sanofi Genzyme and Sienna. Employee and shareholder of Innovaderm Research. JK: Personal fees from Novartis, Pfizer, Amgen, Lilly, Boehringer, BMS, Biogenldec, Janssen, AbbVie, Leo Pharma, ESCALIER, Valeant, Allergan, Aurigene, Sienna, UCB, Allergan, Asana, Celgene, Nimbus, Menlo, Aristea, Sanofi, Sun Pharma, Almirall, Arena, Ventyx, Aclaris, Galapagos. Grants paid to Institution from Novartis, Pfizer, Amgen, Lilly, Boehringer, Innovaderm, BMS, Janssen, AbbVie, Parexel, Leo Pharma, Vitae, Akros, Regeneron, Allergan, Novan, Biogen MA, Sienna, UCB, Celgene, Botanix, Incyte, Avillion, Exicure. JH: consultant for Pfizer, Genzyme/Sanofi, Aclaris Therapeutics, Incyte, Theos Medicines, Sun Pharmaceuticals, LEO Pharma, Villaris Therapeutics, Dermavant, Temprian, AbbVie, Inc., Janssen, TeVido BioDevices, EMD Serono, Almirall, Boston Pharma, Sonoma Biotherapeutics, Inc., Methuselah Health, Twi Biotech, Pandion, Cogen Therapeutics, Inc., Admirx and BridgeBio. Investigator for Pfizer, Genzyme/Sanofi, Aclaris Therapeutics, Incyte, Theos Medicines, Sun Pharmaceuticals, LEO Pharma, Villaris Therapeutics, Dermavant, AbbVie, Inc., TeVido BioDevices, EMD Serono and Pandion. Equity in TeVido Biodevices, Rheos, Villaris Therapeutics, Inc. Scientific Founder of Villaris Therapeutics, Inc. LD: employee at TARGET PharmaSolutions. SEW: employee at TARGET PharmaSolutions. JMC: employee at TARGET PharmaSolutions. DT: is a lecturer and/or consultant for AbbVie, Almirall, Amgen, Asana Biosciences, Biogen Idec, BIOCAD, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, DS-Biopharma, GlaxoSmithKline, Janssen-Cilag, Kyowa Kirin, Leo Pharma, Eli Lilly, Novartis, Regeneron, Sandoz, Sanofi-Aventis and UCB, and received grants from AbbVie and Novartis (paid to institution). EGY: employee of Mount Sinai and has received research funds (grants paid to the institution) from Abbvie, Almirall, Amgen, AnaptysBio, Asana Biosciences, Boerhinger-Ingelhiem, Celgene, Dermavant, DS Biopharma, Eli Lilly, Galderma, Ichnos Sciences, Innovaderm, Janssen, Kiniska, Kyowa Kirin, Leo Pharma, Novan, Pfizer, Ralexar, Regeneron, Sienna Biopharma, UCB, and Union Therapeutics. EGY is also a consultant for Abbvie, Almirall, Amgen, Arena Pharmaceuticals, Asana Biosciences, AstraZeneca Biopharmaceuticals, Boerhinger-Ingelhiem, Cara Therapeutics, Celgene, Concert, DBV, Dermira, DS Biopharma, Eli Lilly, EMD Serono, Escalier, Galderma, Ichnos Sciences, Kyowa Kirin, Leo Pharma, Mitsubishi Tanabe, Pandion Therapeutics, Pfizer, RAPT Therapeutics, Regeneron, Sanofi, Sienna Biopharma, and Union Therapeutics., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)