Safety and Efficacy of Fluticasone Propionate in the Topical Treatment of Skin Diseases

Abstract

Fluticasone propionate – the first carbothioate corticosteroid – has been classified as a potent anti-inflammatory drug for dermatological use. It is available as 0.05% cream and 0.005% ointment formulations for the acute and maintenance treatment of patients with dermatological disorders such as atopic dermatitis, psoriasis and vitiligo. This glucocorticoid is characterized by high lipophilicity, high glucocorticoid receptor binding and activation, and a rapid metabolic turnover in skin. Although skin blanching following fluticasone propionate exceeds that of corticosteroids of medium strength, several clinical trials demonstrate a low potential for cutaneous and systemic side-effects, even in difficult-to-treat areas like the face, the eyelids and intertriginous areas. Even among paediatric patients with atopic dermatitis, fluticasone propionate proved to be safe and effective. These pharmacological and clinical properties are reflected by the high therapeutic index of this glucocorticoid.

A Review of Systemic Corticosteroid Use in Pregnancy and the Risk of Select Pregnancy and Birth Outcomes

“…This review focuses on systemic corticosteroids, rather than inhaled or topical treatments, given the greater systemic bioavailability and systemic effects of these forms, 14-18 and consequently the potential for greater fetal exposure. Careful consideration is given to study design and statistical analysis, with emphasis on the comparison group and mitigation of confounding by disease indication or severity.…”

Two randomized, double-blind, placebo-controlled studies of fluticasone propionate lotion 0.05% for the treatment of atopic dermatitis in subjects from 3 months of age

“…Adverse events were few and the safety profile for FP lotion was consistent with that seen in previous studies with FP cream and ointment. 1,2 In addition, FP did not produce any changes in skin from baseline.…”

“…1,2 The drug is well tolerated, and the risk of systemic and local effects low, even in pediatric subjects as young as 3 months with severe and widespread disease. 1,3,4 A lotion formulation of FP has been developed that may be advantageous in the treatment of young children with extensive disease and for difficult to treat areas, including hirsute areas and intertriginous areas, where creams and ointments are less cosmetically acceptable.…”

An Update on Topical Therapies for Mild-Moderate Psoriasis

“…For example, fluticasone propionate is very lipophilic because of its highly esterified structure. 15,16 Corticosteroids are manufactured in various vehicles, from ointments, creams, and lotions to gels, foams, sprays, and shampoo. [16][17][18] Novel formulations provide additional options for individuals.…”