The safety of halobetasol 0.05% ointment in the treatment of psoriasis

• Published in: Pharmacotherapy Vol. 10; no. 2; p. 107
• Main Authors: Watson, W A, Kalb, R E, Siskin, S B, Freer, J P, Krochmal, L
• Format: Journal Article
• Language: English
• Published: United States 1990
• Subjects: 17-Hydroxycorticosteroids - urine; Adult; Aged; Betamethasone - analogs & derivatives; Clobetasol - analogs & derivatives; Clobetasol - pharmacology; Clobetasol - therapeutic use; Drug Evaluation; Female; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - drug effects; Male; Middle Aged; Ointments; Pituitary-Adrenal System - drug effects; Psoriasis - blood; Psoriasis - drug therapy; Psoriasis - urine; Time Factors
• ISSN: 0277-0008
• DOI: 10.1002/j.1875-9114.1990.tb02557.x

The effects on the hypothalamic-pituitary-adrenal axis of the ultra-high potency corticosteroid halobetasol in the treatment of psoriasis were evaluated in seven patients with extensive, long-standing plaque psoriasis. Each patient applied 3.5 g halobetasol 0.05% ointment in the morning and evening for 7 days. Morning plasma cortisol levels and 24-hour urinary excretion of 17-hydroxycorticosteroid were determined before and on the last 2 days of treatment; plasma cortisol levels were also determined 4 and 5 days after completion of therapy. Morning plasma cortisol concentrations did not decrease significantly during treatment, and no values were below the normal range. Mean 24-hour urinary 17-hydroxycorticosteroid excretion fell from 6.6 +/- 1.4 mg to 5.1 +/- 1.4 mg. Two patients had mild, localized pruritus and stinging with the initial ointment application. No other adverse cutaneous effects were observed. Halobetasol was also clinically efficacious over the 7 days of treatment, based on evaluation of pruritus, erythema, scaling, and plaque elevation. These results demonstrate no adverse effects of the drug on the hypothalamic-pituitary-adrenal axis at doses that are clinically effective in the management of plaque psoriasis.