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Clobetasol propionate emulsion formulation foam 0.05%: review of phase II open-label and phase III randomized controlled trials in steroid-responsive dermatoses in adults and adolescents.
J Am Acad Dermatol. 2008 Sep; 59(3):448-54, 454.e1.JA

Abstract

BACKGROUND

Clobetasol propionate 0.05% emulsion foam was recently developed for use on multiple body sites.

OBJECTIVE

We sought to evaluate safety and efficacy of clobetasol emulsion foam 0.05% to treat steroid-responsive dermatoses in multiple age groups.

METHODS

A phase II open-label study evaluated the effect of clobetasol foam on the hypothalamic-pituitary-adrenal axis in 52 participants aged 6 years or older with mild-to-severe atopic dermatitis (AD). Cosyntropin stimulation test was used to determine the effect of clobetasol foam on hypothalamic-pituitary-adrenal axis, with a normal response considered to be a postinjection serum cortisol level greater than 18 mug/dL. Another phase II open-label pharmacokinetic safety study was conducted in 32 participants aged 12 years or older with mild-to-moderate plaque-type psoriasis. Pharmacokinetic parameters evaluated included maximal plasma concentration of clobetasol propionate, time to achieve maximum concentration, and area under the curve. Two phase III, randomized controlled studies assessed treatment success in participants aged 12 years or older with moderate-to-severe AD (N = 377) or mild-to-moderate plaque-type psoriasis (N = 497). In all studies, participants received study drug for 2 weeks. In the AD study, treatment success was determined using a composite end point requiring an Investigator's Static Global Assessment (ISGA) score of 0 or 1, erythema score of 0 or 1, induration/papulation score of 0 or 1, and improvement in the ISGA score of at least two grades from baseline. Likewise, the study in plaque-type psoriasis used a composite end point requiring an ISGA score of 0 or 1, erythema score of 0 or 1, scaling score of 0 or 1, plaque thickness score of 0, and improvement in the ISGA score of at least two grades from baseline.

RESULTS

Significantly more participants achieved treatment success on clobetasol foam than vehicle foam (P < .0001 and P = .0005 for each study). Reversible hypothalamic-pituitary-adrenal axis suppression was observed in 27% of participants aged 18 years or older and 47% in participants aged between 6 and younger than 12 years, but 0% in participants aged between 12 and younger than 18 years.

LIMITATIONS

The studies evaluated short-term use only.

CONCLUSION

Clobetasol emulsion formulation foam is safe and effective for treatment of moderate-to-severe AD and mild-to-moderate plaque-type psoriasis in patients aged 12 years or older.

Authors+Show Affiliations

Clinical Unit for Research Trials in Skin, Massachusetts General and Brigham and Women's Hospitals, Harvard Medical School, Boston, Massachusetts.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase II
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18539358

Citation

Kimball, Alexa Boer, et al. "Clobetasol Propionate Emulsion Formulation Foam 0.05%: Review of Phase II Open-label and Phase III Randomized Controlled Trials in Steroid-responsive Dermatoses in Adults and Adolescents." Journal of the American Academy of Dermatology, vol. 59, no. 3, 2008, pp. 448-54, 454.e1.
Kimball AB, Gold MH, Zib B, et al. Clobetasol propionate emulsion formulation foam 0.05%: review of phase II open-label and phase III randomized controlled trials in steroid-responsive dermatoses in adults and adolescents. J Am Acad Dermatol. 2008;59(3):448-54, 454.e1.
Kimball, A. B., Gold, M. H., Zib, B., & Davis, M. W. (2008). Clobetasol propionate emulsion formulation foam 0.05%: review of phase II open-label and phase III randomized controlled trials in steroid-responsive dermatoses in adults and adolescents. Journal of the American Academy of Dermatology, 59(3), 448-54, e1. https://doi.org/10.1016/j.jaad.2008.04.020
Kimball AB, et al. Clobetasol Propionate Emulsion Formulation Foam 0.05%: Review of Phase II Open-label and Phase III Randomized Controlled Trials in Steroid-responsive Dermatoses in Adults and Adolescents. J Am Acad Dermatol. 2008;59(3):448-54, 454.e1. PubMed PMID: 18539358.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clobetasol propionate emulsion formulation foam 0.05%: review of phase II open-label and phase III randomized controlled trials in steroid-responsive dermatoses in adults and adolescents. AU - Kimball,Alexa Boer, AU - Gold,Michael H, AU - Zib,Beth, AU - Davis,Mark W, AU - ,, Y1 - 2008/06/09/ PY - 2007/09/21/received PY - 2008/04/04/revised PY - 2008/04/08/accepted PY - 2008/6/10/pubmed PY - 2008/9/5/medline PY - 2008/6/10/entrez SP - 448-54, 454.e1 JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. VL - 59 IS - 3 N2 - BACKGROUND: Clobetasol propionate 0.05% emulsion foam was recently developed for use on multiple body sites. OBJECTIVE: We sought to evaluate safety and efficacy of clobetasol emulsion foam 0.05% to treat steroid-responsive dermatoses in multiple age groups. METHODS: A phase II open-label study evaluated the effect of clobetasol foam on the hypothalamic-pituitary-adrenal axis in 52 participants aged 6 years or older with mild-to-severe atopic dermatitis (AD). Cosyntropin stimulation test was used to determine the effect of clobetasol foam on hypothalamic-pituitary-adrenal axis, with a normal response considered to be a postinjection serum cortisol level greater than 18 mug/dL. Another phase II open-label pharmacokinetic safety study was conducted in 32 participants aged 12 years or older with mild-to-moderate plaque-type psoriasis. Pharmacokinetic parameters evaluated included maximal plasma concentration of clobetasol propionate, time to achieve maximum concentration, and area under the curve. Two phase III, randomized controlled studies assessed treatment success in participants aged 12 years or older with moderate-to-severe AD (N = 377) or mild-to-moderate plaque-type psoriasis (N = 497). In all studies, participants received study drug for 2 weeks. In the AD study, treatment success was determined using a composite end point requiring an Investigator's Static Global Assessment (ISGA) score of 0 or 1, erythema score of 0 or 1, induration/papulation score of 0 or 1, and improvement in the ISGA score of at least two grades from baseline. Likewise, the study in plaque-type psoriasis used a composite end point requiring an ISGA score of 0 or 1, erythema score of 0 or 1, scaling score of 0 or 1, plaque thickness score of 0, and improvement in the ISGA score of at least two grades from baseline. RESULTS: Significantly more participants achieved treatment success on clobetasol foam than vehicle foam (P < .0001 and P = .0005 for each study). Reversible hypothalamic-pituitary-adrenal axis suppression was observed in 27% of participants aged 18 years or older and 47% in participants aged between 6 and younger than 12 years, but 0% in participants aged between 12 and younger than 18 years. LIMITATIONS: The studies evaluated short-term use only. CONCLUSION: Clobetasol emulsion formulation foam is safe and effective for treatment of moderate-to-severe AD and mild-to-moderate plaque-type psoriasis in patients aged 12 years or older. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/18539358/Clobetasol_propionate_emulsion_formulation_foam_0_05:_review_of_phase_II_open_label_and_phase_III_randomized_controlled_trials_in_steroid_responsive_dermatoses_in_adults_and_adolescents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(08)00526-4 DB - PRIME DP - Unbound Medicine ER -