Academic Dermatology Associates, Albuquerque, New Mexico, USA.
Clin Drug Investig. 1998;16(2):111-6. doi: 10.2165/00044011-199816020-00003.
This study evaluated the effects of fluticasone cream 0.05% on the hypothalamopituitary-adrenal (HPA) axis in patients with extensive psoriasis or eczema.
Six inpatients in a hospital setting, three with extensive eczema and three with extensive psoriasis of at least 30% body surface involvement, were enrolled in this study.
In an open-label design, all patients received fluticasone cream 0.05%, 15g applied twice daily without occlusion for 7 consecutive days. The primary outcome measures were HPA-axis suppression (determined by morning plasma cortisol and 24-hour urinary free cortisol concentrations), selected blood chemistries, urinalysis and haematology profile.
During the treatment phase, four of the six patients studied experienced insignificant changes in morning plasma cortisol concentrations. In one patient, a decrease in plasma cortisol concentrations occurred following several days of treatment; these concentrations recovered after 6 to 7 days of treatment. In the remaining patient, a marked decrease in morning plasma cortisol concentrations occurred, which may have been attributed to consumption of alcohol by this patient.
Fluticasone cream 0.05% was well tolerated in patients with extensive eczema or psoriasis and had a low potential for suppressing endogenous cortisol secretion, even when applied to extensive areas of diseased skin for 7 days.
本研究评估了氟替卡松乳膏 0.05% 对患有广泛银屑病或湿疹的患者下丘脑-垂体-肾上腺（HPA）轴的影响。
在医院环境中纳入了 6 名住院患者，其中 3 名患有广泛湿疹，3 名患有至少 30%体表面积受累的广泛银屑病。
采用开放标签设计，所有患者均接受氟替卡松乳膏 0.05%，15g 每日两次，不使用闭塞剂，连续应用 7 天。主要观察指标为 HPA 轴抑制（通过清晨血浆皮质醇和 24 小时尿游离皮质醇浓度确定）、选定的血液化学、尿液分析和血液学特征。
在治疗期间，6 名研究患者中有 4 名经历了清晨血浆皮质醇浓度的无显著变化。在 1 名患者中，皮质醇浓度在治疗几天后下降；这些浓度在治疗 6 至 7 天后恢复。在其余患者中，清晨血浆皮质醇浓度明显下降，可能归因于该患者饮酒。
氟替卡松乳膏 0.05% 在患有广泛湿疹或银屑病的患者中耐受性良好，即使在 7 天内应用于大面积患病皮肤，也具有低的抑制内源性皮质醇分泌的潜力。
