Laquer Vivian, Nguyen Andrea, Squittieri Nicholas, Nguyen Tien
First OC Dermatology, Fountain Valley, California.
Department of Medical Affairs, Sun Pharmaceutical Industries, Inc, Princeton, New Jersey.
JAAD Int. 2021 Nov 23;6:13-19. doi: 10.1016/j.jdin.2021.10.003. eCollection 2022 Mar.
The effects of halobetasol propionate (HBP) lotion 0.05% on the hypothalamic-pituitary-adrenal (HPA) axis have not been previously evaluated in adolescents.
To examine the effect of HBP on HPA axis suppression in patients aged <17 years with plaque psoriasis.
In this phase 4, open-label, multicenter study, patients aged 12 to 16 years 11 months with stable plaque psoriasis covering ≥10% of their body surface area were enrolled. The patients applied an HBP lotion twice daily for up to 2 weeks. The cosyntropin stimulation test was used to determine cortisol levels at the time of screening and at the end of the study to evaluate HPA axis response. The additional endpoints included adverse events, disease severity (measured using Investigator Global Assessment score), and percent body surface area affected.
Sixteen patients were enrolled and included in the safety population; 14 were included in the evaluable population. One patient exhibited an abnormal HPA axis response (16.2 μg/dL) at the end of the study; the response returned to normal at the 6-month follow-up visit. By the end of the study, the Investigator Global Assessment score improved by ≥1 point in most patients; moreover, the percent body surface area affected decreased from 11.5% to 2.8%. One mild adverse event was possibly related to the HBP lotion; however, it resolved and did not cause study discontinuation.
Small sample size.
The HBP lotion 0.05% appeared efficacious and well tolerated in patients as young as 12 years old.
0.05%丙酸氯倍他索(HBP)洗剂对青少年下丘脑-垂体-肾上腺(HPA)轴的影响此前尚未评估。
研究HBP对年龄<17岁的斑块状银屑病患者HPA轴抑制的影响。
在这项4期、开放标签、多中心研究中,纳入了年龄在12至16岁11个月、斑块状银屑病稳定且体表面积受累≥10%的患者。患者每天两次外用HBP洗剂,持续使用2周。采用促肾上腺皮质激素刺激试验来确定筛查时和研究结束时的皮质醇水平,以评估HPA轴反应。其他终点包括不良事件、疾病严重程度(采用研究者整体评估评分衡量)和体表面积受累百分比。
16名患者入组并纳入安全人群;14名患者纳入可评估人群。1名患者在研究结束时出现HPA轴反应异常(16.2μg/dL);在6个月的随访时反应恢复正常。至研究结束时,大多数患者的研究者整体评估评分改善≥1分;此外,体表面积受累百分比从11.5%降至2.8%。1例轻度不良事件可能与HBP洗剂有关;然而,该事件已缓解,未导致研究中断。
样本量小。
0.05%的HBP洗剂在年仅12岁的患者中似乎有效且耐受性良好。