assessing the safety and efficacy of colloidal oat compounds,
but on closer scrutiny that study had methodological problems.
A pair of the methodological flaws in the French study were
that the investigators used oat pollen and not proteins found
in colloidal oatmeal when conducting skin prick tests and IgE
testing. Oat pollen is unlikely to contain the same proteins that
are found in colloidal oatmeal, so an allergic reaction to oat
pollen would not be a predictor of an allergy to proteins found
in colloidal oatmeal.
Boussault and colleagues also used ATPs at three different
concentrations, but the investigators failed to report the
subjects’ reactions at the various concentrations, so clinical
correlation of allergic reactivity and ATPs is uncertain. The ATP
is neither routinely used, nor felt to be of clinical significance
in the US. The ROAT was also problematic, because they were
conducted in the subjects’ home in an unsupervised manner.
Moreover, only 25 of the original 302 subjects had a ROAT performed
with an oat-based emollient and only 7 of the subjects
had a “positive†test.
In conclusion, the FDA has acknowledged colloidal oatmeal to
be a safe and effective skin protectant, and it has been used
for decades to treat AD. In the treatment of AD, much of the
recognized benefit of oats is derived from its phenolic components,
especially avenanthramides, which have empirically
demonstrated robust antioxidant and anti-inflammatory effects.
Further, the majority of studies on oat-based products,
either in atopics or non-atopics, show no propensity toward
adverse events. And although rare cases of clinically relevant
oat allergy may exist, oat-based products are safe and effective
for the treatment of the vast majority of individuals,
including pediatric patients.
DISCLOSUREs
Joseph F. Fowler Jr. has served as a consultant for Johnson &
Johnson, Galderma, Innocutis, and Ranbaxy, and as a speaker
for Galderma, Innocutis, and Ranbaxy, and has received
research grants from Abbott, Allerderm, Allergan, Amgen,
Astellas, Galderma, Genentech, Johnson & Johnson, Lilly,
Medicis, Novartis, Qunnova, Taro, and Valeant.
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AUTHOR CORRESPONDENCE
Joseph F. Fowler Jr. MD FAADFowlerjoe@msn.com