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Journal of Cutaneous Medicine and... 2019Topical corticosteroids (TS) are a treatment for atopic dermatitis (AD) and psoriasis (Ps). We assessed whether use of a TS under conditions designed to enhance... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE:
Topical corticosteroids (TS) are a treatment for atopic dermatitis (AD) and psoriasis (Ps). We assessed whether use of a TS under conditions designed to enhance adherence would be effective in patients who "failed" TS in the outpatient setting.
METHODS:
Individuals with treatment-resistant Ps or AD were recruited (AD, n = 12; Ps, n = 12). Six participants were randomized to each of 2 groups of desoximetasone 0.25% spray alone (n = 6) or desoximetasone spray plus twice-daily phone call reminders to use the medication. Disease severity was assessed.
RESULTS:
In treatment-resistant Ps patients, desoximetasone spray, with reminders, resulted in statistically significant improvement in all outcome measures. In treatment-resistant AD patients, there was statistically significant improvement in some assessments. Despite the very small sample size and short evaluation time, statistically significant changes were detected in this cohort. This is evidence of the large effect size of TS for Ps and AD when the treatment is used.
CONCLUSIONS:
Patients with "treatment-resistant" Ps and AD generally responded well to the use of desoximetasone spray in the trial setting. This may be due to better adherence in the study environment or patients' preference for the spray vehicle. Patient reminders contributed to improved clinical outcomes in Ps and AD patients with "treatment-resistant" disease.
Topics: Administration, Cutaneous; Adult; Aged; Anti-Inflammatory Agents; Dermatitis, Atopic; Desoximetasone; Drug Resistance; Female; Humans; Male; Medication Adherence; Middle Aged; Psoriasis; Reminder Systems; Severity of Illness Index; Telephone; Young Adult
PubMed: 30556414
DOI: 10.1177/1203475418818082 -
Cutis Sep 2018Although topical corticosteroids are the mainstay of treatment of atopic dermatitis (AD), these medications may lose efficacy over time, a phenomenon known as... (Randomized Controlled Trial)
Randomized Controlled Trial
Although topical corticosteroids are the mainstay of treatment of atopic dermatitis (AD), these medications may lose efficacy over time, a phenomenon known as tachyphylaxis. However, the underlying mechanism for tachyphylaxis may be due to lack of treatment adherence rather than loss of efficacy of topical corticosteroids. In this study, we aimed to determine if AD patients who were previously unsuccessfully treated with topical corticosteroids would respond to desoximetasone spray 0.25% under conditions designed to promote good adherence over a 7-day period. At baseline, patients were randomized to receive either twice-daily telephone calls to discuss treatment adherence (intervention group) or no telephone calls (control group) during the study period. The patients improved rapidly. In most patients, treatment-resistant AD is most likely due to poor adherence to treatment rather than loss of drug responsiveness.
Topics: Administration, Topical; Dermatitis, Atopic; Drug Resistance; Female; Glucocorticoids; Humans; Male; Middle Aged; Treatment Failure; Treatment Outcome
PubMed: 30372711
DOI: No ID Found -
Proceedings (Baylor University. Medical... Jul 2018We report the first case of a 34-year-old woman with histiocytoid Sweet syndrome (HSS) that was successfully treated with etanercept. HSS is a rare histological variant...
We report the first case of a 34-year-old woman with histiocytoid Sweet syndrome (HSS) that was successfully treated with etanercept. HSS is a rare histological variant of acute febrile neutrophilic dermatosis that was described by Requena et al in 2005. It is distinguished by dermal infiltration by mononuclear cells with a histiocytic morphology. To date there are three reported cases of the use of etanercept in the treatment of classic febrile neutrophilic dermatosis but none targeting this disease variant. Our patient presented with a 6-month history of scattered erythematous papules on the neck, trunk, and upper and lower limbs bilaterally. Clinical findings and histopathological evaluation were highly suggestive of HSS. After 32 months of refractory disease activity, our patient was initiated on a regimen of etanercept 1 mg/kg subcutaneously twice weekly and topical desoximetasone 0.05% ointment twice daily as required. To date, our patient has achieved 37 months of remission.
PubMed: 29904308
DOI: 10.1080/08998280.2018.1460132 -
The Journal of Clinical and Aesthetic... May 2018The goal of this study was to evaluate efficacy and safety of desoximetasone spray 0.25%, a topical corticosteroid, in the management of scalp and body psoriasis. This...
The goal of this study was to evaluate efficacy and safety of desoximetasone spray 0.25%, a topical corticosteroid, in the management of scalp and body psoriasis. This was an open-label, observational study. Twenty adults aged 18 years or older with chronic scalp psoriasis present on at least 30 percent of the scalp surface area and an Investigator Global Assessment (IGA) scale score of scalp disease of at least 2 on a scale of 0 to 4 were included in the study. Study spray was applied twice daily for four weeks, followed by 12 weeks of twice-daily application for two consecutive days weekly. At Week 4, the mean Physician Global Assessment (PGA) scale score had decreased 54.8 percent, from moderate disease to almost clear. Body surface area (BSA) had decreased by 51.2 percent, BSA × PGA had decreased by 63 percent, and scalp IGA had decreased by 64.5 percent from moderate to almost clear. Additionally, mean Psoriasis Scalp Severity Index (PSSI) score was 27.3±10.0 at baseline and decreased 82.4 percent to 4.8±5.2 and scalp surface area (SSA) was reduced by 70.7 percent at Week 4. The initial Scalp Index score was a mean of 65.7±15.0 at baseline and was reduced by 44.3 percent and 40.8 percent at Weeks 4 and 16, respectively. The initial response was maintained after a change to twice-weekly, twice-daily dosing, with a 48.4-percent decrease in PGA, a 17.1-percent decrease in BSA, a 31.5-percent decrease in BSA × PGA, a 51.6-percent decrease in scalp IGA, a 63.4 percent decrease in PSSI, and a 42.3-percent decrease in SSA seen at Week 16. Minimal adverse events were experienced by seven subjects. Desoximetasone spray 0.25% produced rapid improvements in PGA, BSA, BSA×PGA, scalp IGA, PSSI, SSA.
PubMed: 29785235
DOI: No ID Found -
The Journal of Dermatological Treatment Mar 2020Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may...
Topical corticosteroids, available in an array of vehicles are used to control a variety of inflammatory skin diseases. Patients preferences for different vehicles may affect their willingness to use treatment. We assess corticosteroid vehicle preference and potential impact of topical characteristics on adherence and quality of life in patients with psoriasis. Subjects with psoriasis were recruited from Wake Forest University Dermatology Clinic. Subjects sampled desoximetasone 0.25% spray, betamethasone valerate 0.1% cream, triamcinolone acetonide 0.1% ointment, fluocinonide 0.05% gel, betamethasone valerate 0.1% lotion, clobetasol propionate 0.05% foam, and fluocinonide 0.05% solution in a predetermined randomized order. Subjects completed a Vehicle Preference Measure, Determinants of Adherence Measure, and a Determinants of Quality of Life Measure. Patients preferences for the various products were highly variable. Regarding Determinants of Adherence, patients perception of absorption of the medication was ranked as 'quite important/extremely important' by 85% of total subjects. A majority of patients rated medication side effects as 'quite important/extremely important' when asked to consider topical characteristics effect on quality of life. There was wide variation in patient preference for topical medication vehicles used for treating psoriasis. Several vehicle characteristics were considered important to adherence. Given the marked variation in vehicle preference, topical treatment should be individualized according to patients preferences.
Topics: Administration, Topical; Betamethasone Valerate; Clobetasol; Desoximetasone; Drug Compounding; Female; Fluocinonide; Glucocorticoids; Humans; Male; Middle Aged; Patient Preference; Pharmaceutical Vehicles; Psoriasis; Quality of Life
PubMed: 29770722
DOI: 10.1080/09546634.2018.1473837 -
The Journal of Dermatological Treatment Jun 2018The safety and potential side effects of desoximetasone 0.25% and 0.05% sprays have not previously been studied. The primary objective of this study was to determine the... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The safety and potential side effects of desoximetasone 0.25% and 0.05% sprays have not previously been studied. The primary objective of this study was to determine the irritation potential of desoximetasone 0.25%, 0.05% and vehicle sprays in response to irradiation.
MATERIALS AND METHODS
Thirty-four subjects were enrolled in the study, each with three study treatments (desoximetasone 0.25%, 0.05% topical sprays and vehicle) were applied to two sites each on the back of every subject, with half of the sites irradiated with filtered UV light. Dermal reactions at the test sites were evaluated using a visual scale with corresponding numerical scores that rated the degree of erythema and oedema.
RESULTS
Desoximetasone 0.25%, 0.05%, and vehicle caused no detectable signs of phototoxicity when examined on days 3 and 4. Mean scores of desoximetasone 0.25%, 0.05% and vehicle to non-irradiated treatment areas showed no signs of irritation.
CONCLUSIONS
Our results suggest that regular application of desoximetasone 0.25% and 0.05% topical sprays do not induce photosensitization or photoirritation. The safety of this topical spray may help with clinical management of patients using topical corticosteroids while also receiving therapeutic UV light exposure. Thus, patients can use desoximetasone sprays without concerns of side effects due to therapeutic light or sun exposure.
Topics: Administration, Topical; Adult; Dermatologic Agents; Desoximetasone; Double-Blind Method; Erythema; Female; Humans; Male; Middle Aged; Skin; Ultraviolet Rays; Young Adult
PubMed: 29098908
DOI: 10.1080/09546634.2017.1395797 -
The Journal of Dermatological Treatment May 2018Desoximetasone 0.25% topical spray is a novel formulation that has not been tested or approved for safety and efficacy. The primary objective was to determine the... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Desoximetasone 0.25% topical spray is a novel formulation that has not been tested or approved for safety and efficacy. The primary objective was to determine the potential of desoximetasone 0.25 and 0.05% topical sprays, as well as a vehicle to induce photoallergic skin reaction after repeated topical application and irradiation to the skin using a controlled photopatch testing procedure.
MATERIALS AND METHODS
53 subjects completed the study, each with six application sites (two of each treatment), three of which were irradiated and three non-irradiated, for an induction period of three weeks and then challenge period at week 6.
RESULTS
Desoximetasone 0.25 and 0.05%, as well as vehicle showed no evidence of potential to induce photosensitization. There was statistically significantly greater irritation at the vehicle irradiated site in comparison to the irradiated treatment area of desoximetasone 0.25% (p = .005) and the irradiated treatment area of desoximetasone 0.05% (p = .008).
CONCLUSION
Our results suggest that regular treatment with desoximetasone 0.25 and 0.05% spray, followed by UV light exposure does not induce photosensitization or photo-irritation. These findings increase confidence for the use of this topical spray in eczema or psoriasis patients who may also be receiving UV light therapy and may contribute to the clinical management of these patients.
Topics: Administration, Topical; Adolescent; Adult; Aged; Desoximetasone; Drug Administration Schedule; Drug Compounding; Female; Gastrointestinal Diseases; Humans; Infections; Male; Middle Aged; Skin; Treatment Outcome; Ultraviolet Rays; Young Adult
PubMed: 29098900
DOI: 10.1080/09546634.2017.1395803 -
Journal of Drugs in Dermatology : JDD Oct 2017Topical corticosteroids offer great efficacy in controlling a wide variety of dermatoses. Traditional ointment vehicles are messy and difficult to apply, which might... (Comparative Study)
Comparative Study Randomized Controlled Trial
A Randomized, Double-Blind, Placebo-Controlled Study of the Vasoconstrictor Potency of Topical 0.25% Desoximetasone Spray: A High to Super High Range of Potency (Class I to Class II) Corticosteroid Formulation.
BACKGROUND
Topical corticosteroids offer great efficacy in controlling a wide variety of dermatoses. Traditional ointment vehicles are messy and difficult to apply, which might limit adherence. Alternative vehicle formulations such as topical sprays might improve adherence due to their ease of application. The potency of desoximetasone spray is not fully characterized.
OBJECTIVE
To evaluate the relative vasoconstrictive potency of desoximetasone 0.25% topical spray formulation.
METHODS
This is a randomized, blinded, single-center study comparing the vasoconstrictive properties of desoximetasone 0.25% topical spray to placebo and seven other known potency topical corticosteroid formulations. The primary endpoint was the degree of vasoconstriction measured using a colorimeter device.
RESULTS
Thirty-two healthy subjects met eligibility criteria. Desoximetasone 0.25% topical spray (REGWQ Grouping = A) showed a trend toward greater vasoconstrictive potency compared to clobetasol propionate 0.05% spray (REGWQ Grouping = A). No adverse or serious events were reported.
LIMITATIONS
The trial enrolled 90% females, which may affect the external validity of the study. Different populations may respond differently to desoximetasone spray.
CONCLUSIONS
Desoximetasone 0.25% topical spray is a high to super high range of potency (Class I to Class II) steroid formulation. Given the cosmetic acceptability of spray products, we anticipate that this type of product would be highly effective for the treatment of inflammatory diseases in clinical practice.
J Drugs Dermatol. 2017;16(10):972-975.
.Topics: Administration, Cutaneous; Adolescent; Adult; Anti-Inflammatory Agents; Clobetasol; Desoximetasone; Double-Blind Method; Female; Glucocorticoids; Humans; Male; Middle Aged; Vasoconstriction; Vasoconstrictor Agents; Young Adult
PubMed: 29036250
DOI: No ID Found -
Journal of Drugs in Dermatology : JDD Sep 2017Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disorder. One of the most disturbing symptoms of AD is pruritus. The first line treatment for AD is... (Clinical Trial)
Clinical Trial
BACKGROUND
Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disorder. One of the most disturbing symptoms of AD is pruritus. The first line treatment for AD is topical corticosteroids, topical immunomodulators, topical barrier creams, oral antihistamines, and systemic treatments. Desoximetasone 0.25% spray is a superpotent topical corticosteroid delivered in a novel way and it may be a suitable option for the treatment of pruritus in adult atopic dermatitis patients.
STUDY DESIGN
A single-center, open labeled pilot study was conducted to investigate the efficacy and safety of desoximetasone 0.25% spray for pruritus in adult atopic dermatitis patients.
RESULTS
Twice daily application of desoximetasone 0.25% spray to affected areas resulted in a significant reduction in all outcomes (IGA, pruritus, VAS assessment of pruritus) within 1 week of initiation of treatment. The reductions exhibited were sustained throughout the study period of 4 weeks. Significant improvements in quality of life, as measured by the DLQI, were observed. No adverse events were reported.
CONCLUSION
Desoximetasone 0.25% spray is effective for treating pruritic symptoms of AD. Given its efficacy and convenience as a spray, desoximetasone 0.25% spray should continue to be evaluated as a treatment for AD in larger trials.
J Drugs Dermatol. 2017;16(9):919-922.
.Topics: Administration, Cutaneous; Adult; Dermatitis, Atopic; Dermatologic Agents; Desoximetasone; Female; Glucocorticoids; Humans; Male; Middle Aged; Pilot Projects; Pruritus; Quality of Life; Treatment Outcome
PubMed: 28915287
DOI: No ID Found -
Journal of Drugs in Dermatology : JDD Aug 2017
BACKGROUND: Topical corticosteroids are the most common dermatologic medications and are available in numerous different vehicles. Adherence is limited by traditional... (Randomized Controlled Trial)
Randomized Controlled Trial
UNLABELLED
BACKGROUND: Topical corticosteroids are the most common dermatologic medications and are available in numerous different vehicles. Adherence is limited by traditional vehicles because they are messy and time consuming to apply. The preferred spray formulations have the advantage of being applied with ease, resulting in improved adherence and subsequently improved psoriasis. One limitation of topical treatments, especially spray vehicles, is the potential for irritation and sensitization.
OBJECTIVE: To evaluate the irritation and sensitization potential of topical desoximetasone spray formulation.
METHODS: A multicenter, double-blinded, randomized, controlled study assessed the irritancy and sensitization of 0.25% and 0.05% topical desoximetasone spray. Controls included vehicle, a positive control (0.1% sodium lauryl sulfate), negative control (0.9% saline), and an active comparator control (clobetasol spray). The primary outcome of the study was to evaluate the difference in mean cumulative irritation and potential sensitization response of desoximetasone 0.25% and 0.05% topical sprays.
RESULTS: Of the 297 enrolled, 269 completed the study per protocol for the irritation phase and 250 completed the protocol for the sensitization phase. At 22 days, desoximetasone 0.25 and 0.5% spray were less irritating than clobetasol 0.05% spray; mean irritation score difference of -0.46 and -0.57, respectively. Median total irritation score over the 22 days was 0 for all products. No subjects demonstrated any sensitization reaction to any of the six products. No serious adverse reactions were reported.
LIMITATIONS: Selection bias, use of a healthy population, limits the external validity. In addition, the duration of the study was short lived, unlike numerous inflammatory skin diseases.
CONCLUSIONS
Desoximetasone spray has little potential for irritation or sensitization. The availability of another spray option for patients desiring less messy treatment may facilitate better adherence and treatment outcomes.
J Drugs Dermatol. 2017;16(8):755-758.
.Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Dermatologic Agents; Desoximetasone; Double-Blind Method; Drug Compounding; Female; Humans; Male; Medication Adherence; Middle Aged; North Carolina; Pharmaceutical Vehicles; Treatment Outcome; Young Adult
PubMed: 28809990
DOI: No ID Found