Whole systems and acupuncture (including TCM and Ayurveda)
Secondary Topic: State of the science/evidence base for integrative modalities
Tertiary Topic: Natural products/botanicals/supplements
Traditional, complementary and alternative medicine for treatment of atopic eczema in children under 13 years: a systematic review of randomized clinical trials
Chun-li Lu, Master ; Xue-han Liu, Master , Beijing University of Chinese Medicine , Beijing, China; Trine Stub, PhD, The National Research Center in Complementary and Alternative Medicine , Tromso, Norway; Agnete E. Kristoffersen, Doctor; ArneJohan Norheim, Doctor, The National Research Center in Complementary and Alternative Medicine, Tromso, Norway; Frauke Musial, Doctor, The National Research Center in Complementary and Alternative Medicine , Tromso, Norway; Terje Araek, Doctor, The National Research Center in Complementary and Alternative Medicine, Tromso, Norway; Vinjar Fonnebo, Doctor, The National Research Center in Complementary and Alternative Medicine , Tromso, Norway; Jian-ping Liu, Professor, Beijing University of Chinese Medicine, The Arctic University of Norway, Beijing, China
Late Breaker: No
To evaluate the beneficial effect and safety of traditional, complementary and alternative medicines (TCAM) for children under 13 years with atopic eczema (AE).
We conducted literature searching in 10 Chinese and English databases from the inception to May 2017 to identify randomized clinical trials (RCTs) and extracted data in duplicate. Children under 13 years diagnosed with AE by defined criteria or validated instruments, and TCAM used alone or in combination with conventional therapies were included. Data were extracted and analyzed using RevMan 5.3. We used the Cochrane "Risk of bias" tool to assess the methodological quality, classified as "low risk", "high risk", or "unclear risk". Relative risk (RR) with 95% confidence interval (CI) was used for dichotomous data.
111 RCTs (involving 8797 children with AE) were included (Fig 1). The methodological quality was of unclear risk of bias in general (Fig 2). The trials tested 53 different types of TCAM for children with AE.
For clinical effectiveness (defined as 50% global symptom improvement like itch, skin lesions, swelling, and papula), 36 trials showed better effect from TCAM (RR 1.37, 95% CI 1.24-1.52) in addition to usual care, and 59 trials showed better effect from TCAM alone (RR 1.33, 1.28-1.37) compared with usual care, and two trials showed beneficial effect from TCAM (RR 0.92, 0.70-1.20) compared with placebo.
For 6-month follow-up, nine trials reported lower relapse rate from TCAM+usual care (RR 0.31, 0.23-0.42) comparing with usual care, and another nine trials reported lower relapse rate from TCAM alone (RR 0.41, 0.21-0.82) compared with usual care. Nine trials reported non-serious adverse events in relation to TCAM.
TCAM may reduce symptoms and the relapse rate in children with AE. The safety of TCAM remains unclear due to insufficient reporting. Well-designed, adequately powered and further rigorous RCTs are warranted.