Topical fluticasone propionate: intervention and maintenance treatment options of atopic dermatitis based on a high therapeutic index

Abstract

Fluticasone propionate (FP), a medium potent glucocorticoid (class III) of carbothioate nature with a favourable benefit/risk ratio, has emerged as a standard medication for the topical treatment of inflammatory skin disorders, in particular atopic dermatitis (AD). FP is available as a 0.05% cream and a 0.005% ointment formulation. The glucocorticoid is characterized by high lipophilicity, high affinity binding to the glucocorticoid receptor and a rapid hepatic biotransformation. Though skin blanching following topical application of FP surpasses that given with glucocorticoids of medium strength, clinical trials show a low potential of FP for local and systemic adverse effects. Even in paediatric patients with AD as well as in difficult-to-treat areas like face, eyelids and intertriginous areas, FP proved to be both effective and safe. Thus, the therapeutic effects of FP clearly outweigh the unwanted effects. Correspondingly, a therapeutic index of 2.0 can be attributed to this glucocorticoid. In this respect, topical FP does not differ from other topical glucocorticoids with increased benefit-to-risk ratio, e.g. prednicarbate, methylprednisolone aceponate and mometasone furoate. However, randomized controlled trials do not only support conventional intervention but also innovative maintenance treatment.

Development and Statistical Optimization of Solid Lipid Nanoparticle Formulations of Fluticasone Propionate

“…Fluticasone propionate (FP) is a synthetic trifluorinated topical corticosteroid and has been classified as a potent anti-inflammatory, immunosuppressive and antiproliferative drug for the therapy of skin disorders such as atopic dermatitis and psoriasis 4,5 . It is a highly lipophilic substance and is characterized by high glucocorticoid receptor binding and activation 2 .…”

“…It is a highly lipophilic substance and is characterized by high glucocorticoid receptor binding and activation 2 . FP is available in 0.005% ointment and 0.05% cream formulations for the treatment of the inflammatory skin disorders which are responsive to corticosteroids 5,6 .…”

Steroid Hormones

“…Fluticasone propionate (27.1.14) is used for the prophylaxis of asthma and to prevent, ease, or treat allergic rhinitis and various skin disorders [35][36][37][38][39][40][41].…”

Atopic Dermatitis: New Targets of Therapy

“…В другом исследовании с целью предотвращения обострений АтД у больных было предложено нанесе-ние флутиказона пропионата на неповрежденную кожу 2 раза/нед [9]. Такая стратегия более тщательно иссле-дована на примере топического ингибитора кальцинев-рина такролимуса [7,10].…”