title: Effect on plasma cortisol level and urinary cortisol excretion, in healthy volunteers, after application of three different topical steroid ointments under occlusion.
abstract: The systemic effect of the topical glucocorticoid ointments budesonide 0.025% (Preferid), hydrocortisone-17-butyrate 0.1% (Locoid) and betamethasone-17,21-dipropionate 0.5% (Diproderm) was studied in 9 healthy volunteers. Five g ointment was applied on about 13% of the total body surface, using occlusive technique for three consecutive nights. The cortisol values in plasma and urine were measured before, during, and 3 days after applications. Although budesonide and betamethasone-17,21-dipropionate are equipotent drugs from a therapeutic point of view, the halogenated betamethasone-17,21-dipropionate caused significantly greater decrease in both plasma- and urinary cortisol levels. Between the two non-halogenated glucocorticosteroids, budesonide and hydrocortisone-17-butyrate, no significant difference was found despite the large difference in anti-inflammatory effects. The results indicate that it is possible to improve the ratio between the local therapeutic effect and the systemic activity of a glucocorticosteroid. Budesonide represents such an improvement.
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D001623:Betamethasone / Q000031:analogs & derivatives / Q000494:pharmacology; D019819:Budesonide; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology / Q000652:urine; D008297:Male; D009779:Occlusive Dressings; D009824:Ointments; D011282:Pregnenediones / Q000494:pharmacology
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D009824:Ointments; D011282:Pregnenediones; C007975:hydrocortisone-17-butyrate; D019819:Budesonide; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D006854:Hydrocortisone