Efficacy and safety of a new clobetasol propionate 0.05% foam in alopecia areata: a randomized, double‐blind placebo‐controlled trial
- 16 October 2006
- journal article
- research article
- Published by Wiley in Journal of the European Academy of Dermatology and Venereology
- Vol. 20 (10), 1243-1247
- https://doi.org/10.1111/j.1468-3083.2006.01781.x
Abstract
Clinical efficacy of topical corticosteroids in alopecia areata (AA) is still controversial. Positive clinical results have been obtained using ointments with occlusive dressing but this approach has a low patient compliance. Recently, a new topical formulation (thermophobic foam: Versafoam) of clobetasol propionate 0.05% has been introduced on the market (Olux, Mipharm, Milan, Italy) (CF). This formulation is easy to apply. After application to the skin the foam quickly evaporates without residues and it has a good patient compliance. In vitro studies have also shown that this formulation enhances the delivery of the active compound through the skin. To evaluate the efficacy, safety and tolerability of CF in the treatment of moderate to severe AA. Thirty-four patients with moderate to severe AA (eight men, mean age 40+/-13 years) were enrolled in a randomized, double-blind, right-to-left, placebo-controlled, 24-week trial. Alopecia grading score (AGS) was calculated at baseline and after 12 and 24 weeks of treatment using a 0-5 score (0=no alopecia; 5=alopecia totalis). Clobetasol foam and the corresponding placebo foam (PF) were applied twice a day for 5 days/week for 12 weeks (phase 1) using an intrapatient design (right vs. left). From weeks 13 to 24 each enrolled patient continued only with the treatment (both on the right and left site) that was judged to have a greater efficacy than that on the contralateral side (phase 2). The primary outcome of the trial, evaluated on an intention-to-treat basis, was the hair regrowth rate, which was evaluated using a semiquantitative score (RGS) (from 0: no regrowth, to 4: regrowth of 75%). At baseline the AGS was 4.1 (range: 2-5). Nine (26%) patients prematurely concluded the trial. At the end of phase 1, a greater hair regrowth was observed in 89% of the head sites treated with CF vs. 11% in the sites treated with PF. The RGS was 1.2+/-1.6 in the CF-treated sites and 0.4+/-0.8 in the PF-treated sites (P=0.001). A RGS of 2 (hair regrowth of more than 25%) was observed in 42% CF-treated sites and in 13% of PF-treated sites (P=0.027). In seven subjects (20%) a RGS of 3 to 4 (hair regrowth of 50%) was observed in CF-treated sites. In three subjects (9%) a RGS of 4 (hair regrowth of 75%) was observed in CF-treated sites. In one patient only, in a PF-treated region, a RGS of 3 was observed. The AS was reduced to 3.8 by CF treatment at the end of phase 1 and to 3.3 at the end of phase 2 (P=0.01). From weeks 12 to 24 the treatment with CF induced a further increase in the RGS (from 1.2 to 1.5+/-1.4). Forty-seven per cent of CF-treated patients had a RGS of 2 at the end of the trial. A total of eight patients (25%) at the end of the treatment with CF showed a RGS of 3. Folliculitis occurred in two patients. No significant modifications in cortisol and ACTH blood levels were observed during the trial. This new formulation of clobetasol propionate foam is an effective, safe and well-tolerated topical treatment for AA. This formulation has a good cosmetic acceptance and patient compliance profile.Keywords
This publication has 16 references indexed in Scilit:
- Topical immunotherapy with diphencyprone in the treatment of extensive and/or long‐lasting alopecia areataJournal of the European Academy of Dermatology and Venereology, 2005
- Placebo-controlled oral pulse prednisolone therapy in alopecia areataJournal of the American Academy of Dermatology, 2005
- Alopecia areata investigational assessment guidelines–Part IIJournal of the American Academy of Dermatology, 2004
- Serum Antibodies against Human Intracisternal A-type Particle (HIAP) Endogenous Retrovirus in Alopecia Areata Patients: A Hallmark of Autoimmune Disease?Journal of Investigative Dermatology, 2004
- Alopecia areata: Current state of knowledgeJournal of the American Academy of Dermatology, 2004
- Diabetes Prolongs the Inflammatory Response to a Bacterial Stimulus Through Cytokine DysregulationJournal of Investigative Dermatology, 2004
- Randomized Double-blind Placebo-Controlled Trial in the Treatment of Alopecia Areata With 0.25% Desoximetasone CreamArchives of Dermatology, 2000
- Betamethasone valerate foam 0.12%: a novel vehicle with enhanced delivery and efficacyInternational Journal of Dermatology, 1999
- THE PATHOGENESIS OF ALOPECIA AREATADermatologic Clinics, 1996
- Alopecia areata. A review of therapy, efficacy, safety, and mechanismArchives of Dermatology, 1992