fluticasone and Eczema

The aim of this study was to evaluate efficacy, tolerability and safety of a combination treatment with fluticasone propionate 0.05% cream and clobetasole ointment 0.05% in patients suffering from chronic hand eczema.. The study examined 30 patients with a clinical diagnosis of chronic hand eczema.. The treatment with topical corticosteroids resulted effective and topical corticosteroids proved their efficacy in mild and moderate hand eczema.. In according to the severity of the disease, authors suggest two different clinical strategies in the management of hand eczema.

Topics: Administration, Cutaneous; Androstadienes; Anti-Inflammatory Agents; Chronic Disease; Clobetasol; Drug Therapy, Combination; Eczema; Emollients; Fluticasone; Hand Dermatoses; Humans; Ointments; Severity of Illness Index; Skin Cream; Treatment Outcome

Topics: Acetates; Adolescent; Albuterol; Androstadienes; Anti-Asthmatic Agents; Asthma; Black or African American; Child; Cross-Over Studies; Cyclopropanes; Drug Combinations; Drug Monitoring; Eczema; Female; Fluticasone; Fluticasone-Salmeterol Drug Combination; Hispanic or Latino; Humans; Male; Quinolines; Sulfides; White People

The aim of this study was to investigate the effect of iontophoresis combined with local psoralen plus ultraviolet A (PUVA) therapy in chronic foot eczema. A randomized, observer-blinded, multi-centre study was conducted in 48 patients with chronic moderate-to-severe foot eczema randomized to one of 3 groups: In the iontophoresis group local bath-PUVA was preceded by iontophoresis. In the PUVA group only local PUVA was given. The corticosteroid group was treated with fluticasone. All treatments were given for 8 weeks, with an 8-week follow-up period. The primary efficacy parameter was eczema score described by Rosén et al. Secondary efficacy parameters were a global impression by the patient, and the Dermatology Life Quality Index (DLQI). The eczema score and the DLQI decreased significantly over time. There were no significant differences in the decrease in eczema score (p=0.053) and DLQI values (p=0.563) between the 3 treatments. The DLQI values in our chronic foot eczema patients were high. There was no obvious advantage of local bath-PUVA with or with-out iontophoresis over local steroid therapy.

Topics: Administration, Cutaneous; Adrenal Cortex Hormones; Adult; Androstadienes; Combined Modality Therapy; Eczema; Female; Ficusin; Fluticasone; Foot Dermatoses; Humans; Iontophoresis; Male; Middle Aged; Netherlands; Photosensitizing Agents; PUVA Therapy; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; Time Factors; Treatment Outcome

For children who have uncontrolled asthma despite the use of low-dose inhaled corticosteroids (ICS), evidence to guide step-up therapy is lacking.. We randomly assigned 182 children (6 to 17 years of age), who had uncontrolled asthma while receiving 100 microg of fluticasone twice daily, to receive each of three blinded step-up therapies in random order for 16 weeks: 250 microg of fluticasone twice daily (ICS step-up), 100 microg of fluticasone plus 50 microg of a long-acting beta-agonist twice daily (LABA step-up), or 100 microg of fluticasone twice daily plus 5 or 10 mg of a leukotriene-receptor antagonist daily (LTRA step-up). We used a triple-crossover design and a composite of three outcomes (exacerbations, asthma-control days, and the forced expiratory volume in 1 second) to determine whether the frequency of a differential response to the step-up regimens was more than 25%.. A differential response occurred in 161 of 165 patients who were evaluated (P<0.001). The response to LABA step-up therapy was most likely to be the best response, as compared with responses to LTRA step-up (relative probability, 1.6; 95% confidence interval [CI], 1.1 to 2.3; P=0.004) and ICS step-up (relative probability, 1.7; 95% CI, 1.2 to 2.4; P=0.002). Higher scores on the Asthma Control Test before randomization (indicating better control at baseline) predicted a better response to LABA step-up (P=0.009). White race predicted a better response to LABA step-up, whereas black patients were least likely to have a best response to LTRA step-up (P=0.005).. Nearly all the children had a differential response to each step-up therapy. LABA step-up was significantly more likely to provide the best response than either ICS or LTRA step-up. However, many children had a best response to ICS or LTRA step-up therapy, highlighting the need to regularly monitor and appropriately adjust each child's asthma therapy. (ClinicalTrials.gov number, NCT00395304.)

Topics: Acetates; Administration, Inhalation; Administration, Oral; Adolescent; Adrenergic beta-Agonists; Albuterol; Androstadienes; Asthma; Bronchodilator Agents; Child; Cross-Over Studies; Cyclopropanes; Dose-Response Relationship, Drug; Double-Blind Method; Drug Therapy, Combination; Eczema; Female; Fluticasone; Forced Expiratory Volume; Glucocorticoids; Humans; Leukotriene Antagonists; Logistic Models; Male; Prednisone; Quinolines; Salmeterol Xinafoate; Sulfides; Treatment Outcome

The role of inhaled corticosteroids in the treatment of recurrent or persistent wheeze in infancy remains unclear. We evaluated the effect of 3 months of treatment with inhaled fluticasone propionate, 200 microg daily (FP200), on lung function and symptom scores in wheezy infants. Moreover, we evaluated whether infants with atopy and/or eczema respond better to FP200 as compared with non-atopic infants. Forced expiratory flow (Vmax(FRC)) was measured at baseline and after treatment. Sixty-five infants were randomized to receive FP200 or placebo, and 62 infants (mean age, 11.3 months) completed the study. Mean Vmax(FRC), expressed as a Z score, was significantly below normal at baseline and after treatment in both groups. The change from baseline of Vmax(FRC) was not different between the two treatment arms. After 6 weeks of treatment, and not after 13 weeks, the FP200 group had a significantly higher percentage of symptom-free days and a significant reduction in mean daily cough score compared with placebo. Separate analysis of treatment effect in infants with atopy or eczema showed no effect modification. We conclude that in wheezy infants, after 3 months of treatment with fluticasone, there was no improvement in lung function and no reduction in respiratory symptoms compared with placebo.

Topics: Administration, Inhalation; Androstadienes; Bronchodilator Agents; Child, Preschool; Dermatitis, Atopic; Double-Blind Method; Eczema; Female; Fluticasone; Forced Expiratory Volume; Humans; Immunoglobulin E; Infant; Lung; Male; Respiratory Function Tests; Respiratory Sounds; Treatment Outcome

Many uncertainties remain in the diagnosis and treatment of preschool children with asthma symptoms.. We sought to determine the subgroups of preschool children (aged 12-47 months) with recurrent asthma symptoms most likely to respond to inhaled fluticasone propionate (200 microg/d).. Subgroups of pooled data from 2 similar 12-week multicenter studies were analyzed.. Children with frequent symptoms (symptoms on > or =3 days per week and a total of > or =75% days with symptoms during the 4-week run-in period; n = 169) showed a significantly greater increase in days without symptoms after fluticasone propionate treatment (0% to 45%) compared with after placebo treatment (0% to 25%, P =.005). Children with a family history of asthma (n = 213) also had a significantly greater increase in days without symptoms after fluticasone propionate (11% to 54%) compared with after placebo (7% to 35%, P =.002) and a significantly higher proportion of exacerbation-free patients (61% to 76%, P =.02). Children with less frequent symptoms, no family history of asthma, or both showed no significant treatment effect. There seemed to be no association between response to fluticasone propionate and history of rhinitis or eczema or the number of previous exacerbations.. Children with frequent symptoms, a family history of asthma, or both showed the greatest response to fluticasone propionate treatment. These findings may help to predict treatment outcome and guide the management of preschool children with recurrent asthma symptoms.

Topics: Administration, Inhalation; Age Factors; Androstadienes; Anti-Asthmatic Agents; Asthma; Child, Preschool; Double-Blind Method; Eczema; Family Characteristics; Female; Fluticasone; Humans; Infant; Male; Nebulizers and Vaporizers; Placebos; Respiratory Sounds; Rhinitis

The aim of this study was to evaluate the usefulness of fluticasone propionate in various dermatoses and to present the data to non-dermatologists. The study was performed at the Department of Dermatology, University School of Medicine in Poznań. The studied group consisted of 40 cases of various types of eczema, psoriasis vulgaris, DLE, photodermatoses and morphea. Fluticasone propionate cream or ointment was applied to lesional skin twice daily for 7-19 days. Acute eczematous skin lesions significantly improved after the first seven days of treatment, whereas in patients with chronic eczema the good therapeutic results were observed after 14-19 days. Fluticasone propionate was also effective in the treatment of DLE and photodermatoses.

Topics: Administration, Topical; Adolescent; Adult; Aged; Androstadienes; Anti-Inflammatory Agents; Drug Administration Schedule; Eczema; Female; Fluticasone; Glucocorticoids; Humans; Male; Middle Aged; Photosensitivity Disorders; Proteus Infections; Proteus vulgaris; Psoriasis; Scleroderma, Localized; Skin Diseases

This multicenter, double-blind, randomized, parallel, four-week, vehicle-controlled study compared the efficacy and safety of once- and twice-daily application of fluticasone propionate cream, 0.05%, over a twenty-eight-day treatment period in 238 patients with moderate-to-severe eczema. Clinical evaluations, which included the physician's gross assessment, the severity of signs and symptoms, and the patient's subjective evaluation, were conducted at baseline and at weekly intervals following initiation of treatment. Both fluticasone QD and BID were found to be superior to vehicle at each evaluation. Application of fluticasone BID was found to be superior to once-daily application at day 22 based on the physician's gross assessment, and at days 15 and 22 based on the patient's subjective assessment. There were, however, no statistically significant differences between QD and BID application at day 8 and at the end of the twenty-eight-day treatment period. The results of this study suggest that QD application may be recommended for the treatment of moderate-to-severe eczema in most patients. As always, treatment effectiveness should be monitored periodically and BID application may be necessary to maximize therapeutic benefits in some patients.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Androstadienes; Anti-Inflammatory Agents; Child; Double-Blind Method; Drug Administration Schedule; Eczema; Female; Fluticasone; Glucocorticoids; Humans; Male; Middle Aged; Ointments

A randomized, double-blind, parallel group study involving thirteen centers compared the safety, tolerability, and efficacy of twice-daily applications of fluticasone propionate ointment, 0.005%, and betamethasone-17, 21-dipropionate ointment, 0.05%, in ninety-two patients with moderate-to-severe eczema. Safety assessments included routine clinical laboratory evaluations, morning plasma cortisol levels, and reporting of adverse events. Efficacy assessments included (1) physician's gross assessment of clinical response of the target lesion, (2) severity of signs and symptoms of eczema, and (3) patients' assessment of treatment effects. Both treatments were well tolerated and showed minimal suppression of the hypothalamic-pituitary-adrenal axis as evidenced by morning plasma cortisol concentration determinations. Statistically significant improvement in the severity of each sign/symptom was found as early as two weeks following treatment initiation in both groups. The two treatments were found to be similar following two and four weeks of therapy with regard to almost all efficacy variables.

Topics: Administration, Topical; Adolescent; Adult; Aged; Androstadienes; Anti-Inflammatory Agents; Betamethasone; Child; Double-Blind Method; Drug Tolerance; Eczema; Female; Fluticasone; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Safety

This is a randomized, double-blind, parallel-group, multicenter study involving 120 patients comparing the safety and tolerability of two midpotency topical preparations, fluticasone propionate cream, 0.05%, and hydrocortisone-17-butyrate cream, 0.1%, in the treatment of moderate-to-severe eczema. Safety of the study medications was determined over a twelve-week period using laboratory tests for selected fasting blood chemical levels, hematologic analysis, urinalysis, and morning plasma cortisol levels, and by analyzing both the nature and frequency of reported adverse events. Efficacy was evaluated during the first four weeks of the study. None of the fluticasone-treated patients experienced any severe drug-related adverse events, but one hydrocortisone-17-butyrate-treated patient's eczema was severely exacerbated by drug therapy. Plasma cortisol monitoring revealed minimal hypothalamic-pituitary-adrenal axis suppression. Overall, the nature of drug-related adverse events in patients as young as 12 years old treated with fluticasone propionate cream, 0.05%, indicates this topical application was safe and well tolerated throughout the twelve-week study. Fluticasone cream was also found to be similar in efficacy to hydrocortisone-17-butyrate cream.

Topics: Administration, Topical; Adolescent; Adult; Aged; Androstadienes; Anti-Inflammatory Agents; Child; Double-Blind Method; Drug Administration Schedule; Drug Tolerance; Eczema; Female; Fluticasone; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Safety

The clinical efficacy and safety of fluticasone propionate ointment, 0.005%, were compared with those of its vehicle in the treatment of moderate-to-severe eczema of long duration in two multicenter, double-blind, vehicle-controlled, randomized studies. One of the two study medications (up to 100 gm/week) was applied topically to the affected areas of the body twice daily for up to four consecutive weeks. Drug efficacy was measured in terms of three variables: the physician's gross assessment of clinical response of the target lesion, severity scores of individual signs and symptoms, and the patient's subjective assessment of treatment effects. Efficacy and safety were evaluated after seven, fourteen, twenty-one, and twenty-eight days of treatment. The total number of patients in the two studies was 372 (203 in study 1 and 169 in study 2). Fluticasone propionate ointment, 0.005%, was more effective than vehicle at all postbaseline visits in both studies (study 1 P < or = 0.015, study 2 P < or = 0.018). In study 1, approximately 80% of the patients on fluticasone were rated as cleared, excellent, or good by the investigators at treatment endpoint, compared with 38% of those receiving vehicle. In study 2, the sum of 80% of the fluticasone-treated patients was rated as cleared, excellent, or good by the investigators at the end of the study, compared with 34% of those receiving vehicle. The beneficial effect of fluticasone ointment, 0.005%, was early and sustained and was particularly noticeable for pruritus, erythema, and skin thickening. In study 1, no drug-related adverse events were reported in the fluticasone group. Four patients (4.3%) in the vehicle group experienced a total of four drug-related adverse events. The most common was burning/stinging, reported by two patients. In study 2, two patients (2.4%) in the fluticasone-treated group and three (4.1%) in the vehicle group reported a total of five drug-related adverse events, the most common event being pruritus (fluticasone group one patient, vehicle group two patients). These findings show that fluticasone propionate ointment, 0.005%, applied twice daily, is therapeutically superior to the vehicle and is well tolerated.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Androstadienes; Anti-Inflammatory Agents; Child; Double-Blind Method; Drug Tolerance; Eczema; Female; Fluticasone; Glucocorticoids; Humans; Male; Middle Aged; Ointments