Clinical evaluation of clobetasone butyrate: a comparative study of its effects in postoperative inflammation and on intraocular pressure.

Abstract

SUMMARY Clobetasone butyrate, a new corticosteroid with a high topical activity, has been compared with prednisolone phosphate and a placebo in the treatment of inflammation following cataract extraction. These 2 steroids were more effective in relieving postoperative inflammation than placebo (P < 0 05), though no obvious clinical differences between the 2 compounds emerged from this investigation. However, a single-blind comparative study against betamethasone phosphate in patients suspected of having steroid-induced glaucoma showed that, while betamethasone phosphate significantly raised intraocular pressure, clobetasone butyrate had only a minimal effect, and this difference was statistically significant (P <0 02).

A review of evidence guiding the use of corticosteroids in the treatment of intraocular inflammation

“…64 A double-blind study published in 1980 evaluated clobetasone butyrate and failed to show a difference between it and prednisolone acetate in controlling anterior segment inflammation after cataract surgery, while either drug administered four times per day was more effective than placebo. 65 Clinical trials were recently conducted to evaluate loteprednol 0.5% and rimexolone 1%, marketed as anti-inflammatory drugs inducing less intraocular pressure (IOP) elevation than traditional agents. In one trial, loteprednol 0.5% was found superior to placebo in treating inflammation after cataract surgery when used four times daily postoperatively.…”

A Randomized, Comparative Study of Fluorometholone 0.2% and Fluorometholone 0.1% Acetate after Photorefractive Keratectomy

“…All these complications are related to the molecule used and the duration of administration. For this reason we prefer local anti-inflammatory drugs with high anti-inflammatory efficacy and low side effects, such as fluorometholone (21,22). The pharmacological properties of this drug have been well studied.…”

Safety and Efficacy of 0.1% Clobetasone Butyrate Eyedrops in the Treatment of Dry Eye in Sjögren Syndrome

“…Its anti-inflammatory effect proved to be comparable to that of betamethasone, due to the high affinity for glucocorticoid receptors, determined by the chemical structure of both the fluorinated corticosteroids (16–18). The high lipophilicity of the molecule, given by the butyrate group, allows the clobetasone butyrate to concentrate in the corneal epithelium (13) with reduced penetration in the underlying hydrophilic stroma and endothelium and, therefore, with little penetration into the anterior chamber. This renders the molecule particularly suitable for the treatment of ocular surface disorders, even in subjects susceptible to IOP rise after corticosteroid treatment (13, 18).…”

“…The high lipophilicity of the molecule, due to the butyrate group, allows clobetasone to concentrate in the corneal epithelium (12), with increased resistance to penetration in the underlying hydrophilic stroma and in the endothelium. Its penetration into the anterior chamber is, therefore, much lower than the other corticosteroids used for dry eye treatment, with less tendency to raise IOP and augment lens opacity, even in genetically corticosteroidsensible individuals (13). Since dry eye is a chronic disease with recurrent inflammatory episodes, it would be useful to have an effective and safe drug that could be used with few daily instillations, in order to reduce the treatment burden.…”