The Pharmaceutical Journal
Vol 270 No 7254 p854
21 June 2003

This article
Reprint
Photocopy

News summary

Related websites
BMJ (bmj.com)

Twice weekly topical steroid cream may reduce risk of eczema flare up

Using a topical steroid cream twice a week may reduce the risk of flare up in atopic dermatitis, dermatologists say.

The doctors, from various European centres, looked at topical fluticasone in 376 patients who were experiencing a flare-up. Patients applied either fluticasone propionate cream 0.05 per cent or ointment 0.005 per cent, once or twice a day for four weeks to stabilise their condition. Those whose disease was controlled then used emollients daily and continued using their fluticasone formulation, or placebo, on vulnerable areas on two successive evenings a week for 16 weeks.

Median time to relapse was six weeks with emollient alone, compared with more than 16 weeks when twice-weekly steroid was added. Those using the cream were almost six times less likely to have a relapse, with the risk reduced by nearly two for patients applying the ointment.

The authors say that, although such maintenance regimens may be used in practice, few trials had been carried out to support this approach. "This treatment regimen for fluticasone propionate may paradoxically be steroid sparing in patients with atopic dermatitis," they state (BMJ 2003;326:1369).

The authors add that the unexpected difference between formulations requires further investigation, but suggest that poorer compliance with the ointment may have contributed to its apparently lower efficacy in maintenance.