The safety of halobetasol 0.05% ointment in the treatment of psoriasis.
The effects on the hypothalamic-pituitary-adrenal axis of the ultra-high potency corticosteroid halobetasol in the treatment of psoriasis were evaluated in seven patients with extensive, long-standing plaque psoriasis. Each patient applied 3.5 g halobetasol 0.05% ointment in the morning and evening for 7 days. Morning plasma cortisol levels and 24-hour urinary excretion of 17-hydroxycorticosteroid were determined before and on the last 2 days of treatment; plasma cortisol levels were also determined 4 and 5 days after completion of therapy. Morning plasma cortisol concentrations did not decrease significantly during treatment, and no values were below the normal range. Mean 24-hour urinary 17-hydroxycorticosteroid excretion fell from 6.6 +/- 1.4 mg to 5.1 +/- 1.4 mg. Two patients had mild, localized pruritus and stinging with the initial ointment application. No other adverse cutaneous effects were observed. Halobetasol was also clinically efficacious over the 7 days of treatment, based on evaluation of pruritus, erythema, scaling, and plaque elevation. These results demonstrate no adverse effects of the drug on the hypothalamic-pituitary-adrenal axis at doses that are clinically effective in the management of plaque psoriasis.
Watson
W A
WA
Department of Medicine, Millard Fillmore Hospital, Buffalo, New York.
Kalb
R E
RE
Siskin
S B
SB
Freer
J P
JP
Krochmal
L
L
D015065:17-Hydroxycorticosteroids / Q000652:urine; D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000031:analogs & derivatives*; D002990:Clobetasol / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D013997:Time Factors
D015065:17-Hydroxycorticosteroids; D009824:Ointments; D001623:Betamethasone; C064466:halobetasol; D002990:Clobetasol; D006854:Hydrocortisone