The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Steven R. Feldman - One of the best experts on this subject based on the ideXlab platform.
-
Clobetasol propionate for psoriasis are ointments really more potent
Journal of Drugs in Dermatology, 2006Co-Authors: Lindsey Warino, Rajesh Balkrishnan, Steven R. FeldmanAbstract:BACKGROUND: Clobetasol propionate is the most common topical therapy used for psoriasis in the US. Conventional dermatologic wisdom is that ointment preparations provide the highest potency (due to their occlusive nature and moisturizing ability) and are best suited for psoriasis. However, patients often find application of ointment to be messy, raising concerns about both short-term and long-term adherence to treatment. This article reviews the current literature and assesses the relative potency of Clobetasol propionate ointment compared to other Clobetasol propionate preparations in the treatment of psoriasis. Relevant literature was identified by PubMed and Google searches. We included studies of psoriasis that reported the percentage of subjects that achieved desired efficacy endpoints, as well as studies that reported the subjects' mean change in symptoms from baseline. We excluded studies conducted before 1980 and those that allowed concomitant treatments. OBSERVATIONS: Efficacy rates ranged from 17% to 80% for the different vehicles: ointment, solution, foam, cream, lotion, shampoo, and emollient. CONCLUSIONS: Clobetasol propionate is a very effective treatment for psoriasis. Ointment preparations have similar efficacy to other preparations in clinical trial situations. In clinical practice, a situation in which patient preferences are more likely to affect compliance, it may be best to choose whichever vehicle patients find preferable.
-
Clobetasol propionate lotion an efficient and safe alternative to Clobetasol propionate emollient cream in subjects with moderate to severe plaque type psoriasis
Journal of Dermatological Treatment, 2005Co-Authors: Nicholas J Lowe, Steven R. Feldman, Daniel W Sherer, Jonathan Weiss, Joel S Shavin, Valerie Foley, Pascale SotoAbstract:Background: Various formulations of Clobetasol propionate are currently used to treat psoriasis due to its anti‐inflammatory, anti‐pruritic, vasoconstrictive and immunomodulating properties. Objective: To assess the efficacy, safety and remission profile of Clobetasol propionate lotion compared to that of Clobetasol propionate emollient cream and lotion vehicle in subjects with moderate to severe plaque‐type psoriasis. Methods: Multicentre, investigator‐blind, randomized, active‐ and vehicle‐controlled, parallel‐group study. Results: A total of 192 subjects were treated: 82 with Clobetasol propionate lotion, 81 with Clobetasol propionate cream and 29 with the vehicle. Clobetasol propionate lotion was significantly more effective than vehicle lotion and was comparable in efficacy to the emollient cream after 4 weeks of treatment. Treatment success was higher for subjects in the Clobetasol propionate lotion group than in the emollient cream group after 4 weeks of a treatment‐free follow‐up period. Clobetaso...
-
Relative efficacy and interchangeability of various Clobetasol propionate vehicles in the management of steroid-responsive dermatoses
Current Therapeutic Research - Clinical and Experimental, 2005Co-Authors: Steven R. FeldmanAbstract:Background: Topical corticosteroids have long been the cornerstone in thetreatment of steroid-responsive dermatoses. Despite the effectiveness of these formulations, there is a misperception that drugs delivered via ointments are more potent than those delivered via other vehicles. Potency, however, is a complex function of the physical and chemical properties of both the active ingredient and its vehicle. Studies have determined that newer vehicles (eg, lotions), particularly those in the super-high-potency class, not only heighten the ability of the active ingredient to penetrate skin but also are preferred by patients over ointments and creams. Objective: This review of the literature investigates the effectiveness andtolerability of a high-potency corticosteroid lotion compared with cream or emollient cream formulations in treating moderate to severe plaque-type psoriasis and atopic dermatitis. Methods: A literature search was conducted of US and international published clinical trials (1975 to November 2004) comparing all potencies of topical corticosteroid cream and lotion formulations using MEDLINE and the Web sites of individual dermatologic journals. No specific study designs were excluded from this search. Search terms included corticosteroid-responsive dermatoses, creams versus lotions, topical corticosteroid clinical trials, plaque-type psoriasis, atopic dermatitis, Clobetasol propionate, drug bioavailability, Class I topical agents, and vasoconstriction. The primary diagnoses were moderate to severe plaque-type psoriasis and atopic dermatitis. Two unpublished clinical investigations comparing Clobetasol propionate lotion 0.05% with Clobetasol propionate cream 0.05% and emollient cream 0.05% in a total of 421 patients were also included. Results: In the 20 published and 2 unpublished trials identified and reviewed, the response rates were comparable between the lotion and cream formulations. In addition, in a psoriasis study, Clobetasol lotion received significantly better cosmetic-acceptability ratings compared with Clobetasol cream (P < 0.05). Conclusion: In the studies reviewed, the effectiveness and tolerability of Clobetasollotion were comparable to those of Clobetasol cream and emollient cream in studies in adults with moderate to severe psoriasis or atopic dermatitis. Copyright © 2005 Excerpta Medica, Inc.
-
the use of 0 25 zinc pyrithione spray does not enhance the efficacy of Clobetasol propionate 0 05 foam in the treatment of psoriasis
Journal of The American Academy of Dermatology, 2003Co-Authors: Tamara Salam Housman, Alan B. Fleischer, Kimberly A Keil, Beverly G Mellen, Martha Ann Mccarty, Steven R. FeldmanAbstract:Abstract Background: It was discovered that Skin Cap (Cheminova Internacional S.A., Madrid, Spain), an over-the-counter psoriasis therapy with zinc pyrithione, contained Clobetasol propionate and it was withdrawn from the market by the US Food and Drug Administration review. Some suggested that there might be a synergistic effect of zinc pyrithione with Clobetasol propionate. Objective: We sought to evaluate the efficacy of Clobetasol propionate 0.05% foam with and without the coadministration of a topical 0.25% zinc pyrithione spray in treating psoriasis involving sites other than the scalp. Methods: We conducted a randomized, double-blind, right/left study of patients with mild to moderate, generally symmetric, plaque-type psoriasis. Patients were assigned to treatment with Clobetasol propionate foam on all psoriatic lesions and then randomly assigned to use zinc pyrithione spray to either the right or left side of their body (vehicle spray to be applied to the opposite side). There was a 2-week treatment phase (visits at baseline, week 1, and week 2) and a follow-up phase (visit at week 4), and all treatments were administered twice daily for 2 weeks. The primary outcome measure was the change from baseline to week 2 in the composite score of the signs of psoriasis (erythema, scaling, plaque thickness) for symmetric target lesions. Results: A total of 25 patients were enrolled; 24 completed the trial and 1 was lost to follow up. Of those who completed the study, 63% (15 of 24) were men, and the mean age (±SD) was 50 years (±12.2). After 2 weeks of therapy, the average decline in the composite score was 3.5 (±1.8) for monotherapy (Clobetasol propionate foam and vehicle) and, similarly, 3.3 (±1.8) for Clobetasol propionate foam plus zinc pyrithione spray ( P = .5). Discussion: Zinc pyrithione spray does not appear to enhance the efficacy of Clobetasol propionate foam after 2 weeks of therapy. (J Am Acad Dermatol 2003;49:79-82.)
-
bioavailability of Clobetasol propionate in different vehicles
Skin Pharmacology and Physiology, 2003Co-Authors: T J Franz, Steven R. Feldman, P A Lehman, M C SpellmanAbstract:Topical Clobetasol propionate is widely used for the treatment of psoriasis. One formulation of Clobetasol propionate, Skin Cap, was thought by some practitioners and patients to be more effective tha
Julie Powell - One of the best experts on this subject based on the ideXlab platform.
-
a double blind randomized prospective study evaluating topical Clobetasol propionate 0 05 versus topical tacrolimus 0 1 in patients with vulvar lichen sclerosus
Journal of The American Academy of Dermatology, 2014Co-Authors: Deana Funaro, Audrey Lovett, Nathalie Leroux, Julie PowellAbstract:Background Vulvar lichen sclerosus is a chronic condition usually responsive to topical corticosteroids. Objective We sought to evaluate the efficacy (reduction of signs and symptoms) and safety of Clobetasol propionate 0.05% and tacrolimus 0.1% in the treatment of vulvar lichen sclerosus. Method This double-blind, randomized study comparing 2 treatments over a 3-month period, enrolled 58 female patients with newly diagnosed vulvar lichen sclerosus or untreated vulvar lichen sclerosus for at least 1 month. Results In all, 55 patients were included in the statistical analysis. A total of 28 patients were assigned to the tacrolimus group and 27 patients to the Clobetasol group. Both groups showed a significant difference in the decrease of symptoms and signs of lichen sclerosus. At the end of the study, 28 participants (19 tacrolimus and 9 Clobetasol) still had some clinical signs of lichen sclerosus (χ 2 = 6.56, P = .015). However, a significantly higher number of patients in the Clobetasol group (n = 15) had absence of signs and symptoms of lichen sclerosus (χ 2 = 10.35, P = .002; χ 2 = 10.35, P = .002). No adverse events were reported. Limitations Short length of trial and recruitment through our vulvar disease referral center are limitations. Conclusion This study showed that topical Clobetasol propionate was significantly more effective in treating vulvar lichen sclerosus than topical tacrolimus.
Deana Funaro - One of the best experts on this subject based on the ideXlab platform.
-
a double blind randomized prospective study evaluating topical Clobetasol propionate 0 05 versus topical tacrolimus 0 1 in patients with vulvar lichen sclerosus
Journal of The American Academy of Dermatology, 2014Co-Authors: Deana Funaro, Audrey Lovett, Nathalie Leroux, Julie PowellAbstract:Background Vulvar lichen sclerosus is a chronic condition usually responsive to topical corticosteroids. Objective We sought to evaluate the efficacy (reduction of signs and symptoms) and safety of Clobetasol propionate 0.05% and tacrolimus 0.1% in the treatment of vulvar lichen sclerosus. Method This double-blind, randomized study comparing 2 treatments over a 3-month period, enrolled 58 female patients with newly diagnosed vulvar lichen sclerosus or untreated vulvar lichen sclerosus for at least 1 month. Results In all, 55 patients were included in the statistical analysis. A total of 28 patients were assigned to the tacrolimus group and 27 patients to the Clobetasol group. Both groups showed a significant difference in the decrease of symptoms and signs of lichen sclerosus. At the end of the study, 28 participants (19 tacrolimus and 9 Clobetasol) still had some clinical signs of lichen sclerosus (χ 2 = 6.56, P = .015). However, a significantly higher number of patients in the Clobetasol group (n = 15) had absence of signs and symptoms of lichen sclerosus (χ 2 = 10.35, P = .002; χ 2 = 10.35, P = .002). No adverse events were reported. Limitations Short length of trial and recruitment through our vulvar disease referral center are limitations. Conclusion This study showed that topical Clobetasol propionate was significantly more effective in treating vulvar lichen sclerosus than topical tacrolimus.
H Abramovici - One of the best experts on this subject based on the ideXlab platform.
-
Clobetasol dipropionate 0 05 versus testosterone propionate 2 topical application for severe vulvar lichen sclerosus
American Journal of Obstetrics and Gynecology, 1998Co-Authors: Jacob Bornstein, Sigal Heifetz, Yehudith Kellner, Zmira Stolar, H AbramoviciAbstract:Abstract OBJECTIVE: Our goal was to evaluate short-term (3 months) and long-term (1 year) treatment of vulvar lichen sclerosus, by comparing topical application of testosterone propionate 2% in petrolatum with the corticosteroid Clobetasol dipropionate 0.05%. STUDY DESIGN: There were 20 women in each treatment group. The patients' symptoms and the gynecologist's examination findings were recorded before treatment, at 3 months, and at 1 year after initiation of therapy. RESULTS: The symptomatic (subjective) effect of Clobetasol treatment was similar to that of testosterone at the 3-month follow-up (p ≤ 0.34), although objectively the signs of lichen sclerosus had improved more in the Clobetasol group (p ≤ 0.033). Both symptoms and signs were significantly more improved in the Clobetasol-treated group at the 1-year follow-up examination (p ≤ 0.02). Seventy percent of women treated by testosterone discontinued treatment because of a lack of response, whereas only 10% of the women treated with Clobetasol stopped the treatment for that reason (p ≤ 0.00042). CONCLUSIONS: Clobetasol is more effective than testosterone in the treatment of women with lichen sclerosus, especially in the long term. (Am J Obstet Gynecol 1998;178:80-4.)
Ilan Vidavsky - One of the best experts on this subject based on the ideXlab platform.
-
detection of Clobetasol propionate as an undeclared steroid in zinc pyrithione formulations by high performance liquid chromatography with rapid scanning ultraviolet spectroscopy and mass spectrometry
Journal of Chromatography A, 1998Co-Authors: John C Reepmeyer, Larry K Revelle, Ilan VidavskyAbstract:Abstract Clobetasol propionate, an anti-inflammatory glucocorticosteroid, was detected in an over-the-counter topical drug product with no indication on the label of this compound as an ingredient. The product was formulated as a topical spray, a cream, or a shampoo and labeled to contain zinc pyrithione as the active ingredient. The finding of Clobetasol propionate in the pharmaceutical products was shown by comparison to an authenticated standard of Clobetasol propionate by retention time on normal-phase and reversed-phase HPLC, UV spectroscopy, LC–MS and LC–MS–MS. A simple method was developed and validated for the assay of Clobetasol propionate by isocratic reversed-phase HPLC. Several lots contained Clobetasol propionate at therapeutic levels of 0.02–0.06%. Zinc pyrithione formulations from two other manufacturers were free of Clobetasol propionate.