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PubMed2001

Roentgenographic evaluation of ossification and calcification of the lumbar spinal canal after intradiscal betamethasone injection.

There have been reports of lumbar spinal canal ossification and calcification after triamcinolone intradiscal injection therapy. Our objective was to observe the roentgenographic changes after betamethasone intradiscal injection therapy for lumbar disc diseases. The subjects were 183 patients (498 discs; 130 men and 53 women) who underwent discography and betamethasone intradiscal injection therapy and were followed for a mean of 5 years and 7 months. Ossification and calcification appeared de novo (three patients, three discs) or enlarged (four patients, five discs) in the outer layer of the posterior annulus fibrosus or posterior longitudinal ligament in eight discs among seven patients (3.8%). The incidence and degree of ossification and calcification in our patients were significantly lower than those reported in previous studies, and a long time elapsed before ossification and calcification appeared or enlarged. Intradiscal injection of betamethasone did not appear to confer any incremental relative risk for lumbar spinal canal ossification and calcification based on review of follow-up roentgenographs.

Adolescent↗

PubMed1993

The pre- and postnatal development of Na+/K(+)-ATPase in gastrointestinal organs of the rat: effect of betamethasone treatment.

Developmental changes in Na+/K(+)-ATPase enzyme activity have been documented postnatally in a number of organs, but little is known about prenatal levels or the factors affecting them. This study determined the normal developmental patterns of Na+/K(+)-ATPase activity in the pancreas, liver, small intestine, kidneys, and colon of pre- and postnatal rats. In addition the effect of betamethasone administration on enzyme activity was determined both antenatally and postnatally. The individual organs showed a variable pattern of maturational change in enzyme activity. In the pancreas, changes in Na+/K(+)-ATPase activity appeared to reflect the changing ratio of ductular to acinar cells. The pattern of enzyme activity in the small intestine was similar to that of the kidney and was inversely related to that of the colon. Enzyme induction by administration of betamethasone was also variable and bore no relationship to the DNA/protein ratio. In the preterm rat, betamethasone increased the Na+/K(+)-ATPase activity only in the colon. Use of steroids to increase enzyme activity in the colon at an early stage of development may have therapeutic implications for treating abnormalities of potassium and sodium homeostasis in the preterm infant.

Animals↗

PubMed2005

The use of betamethasone to manage the trapped penis following neonatal circumcision.

PURPOSE: The trapped penis results from cicatricial scar formation over the glans after circumcision. Management of this problem has been surgical either by incision of the cicatrix or formal surgical reconstruction. We report a series of neonates with trapped penises which were effectively managed primarily with topical steroid cream with operative intervention reserved for failed cases. MATERIALS AND METHODS: A retrospective study of 14 neonates who presented with a trapped penis treated with topical betamethasone cream was performed. Each child underwent topical application of 0.05% betamethasone 3 times daily for 3 weeks in conjunction with manual retraction that continued after the steroid course. The need for surgical intervention was assessed during and after the treatment period. RESULTS: All 14 boys were evaluated by the pediatric urologist within 4 weeks of circumcision. Each child had a trapped penis with a dense cicatrix of the residual foreskin distal to the glans. All parents were compliant with the regimen. There were no untoward effects of topical steroid application. Following therapy 11 boys (79%) demonstrated softening of the cicatrix with easy exposure of the glans in 2 and mild persistence of the cicatrix amenable to vertical relaxation incision in 2. The cicatrix persisted in 3 boys (14%) who required formal operative repair at ages 5 to 8 months. CONCLUSIONS: The combination of topical betamethasone and manual retraction is effective in managing the trapped penis. This combination may affect complete resolution of the condition in the majority of patients. Otherwise, this regimen may release the closing cicatrix and allow for simple incision of the constricting phimotic ring, thus reducing the need for formal surgical repair.

Administration, Topical↗

PubMed2001

Treatment of intestinal graft-versus-host disease using betamethasone enemas.

Intestinal graft-versus-host disease (GVHD) can readily easily induce generalized metabolic disturbance that influences morbidity and mortality after allogeneic bone marrow transplantation. Although adding a new drug or increasing the doses of immunosuppressive agents will probably be effective for controlling intestinal GVHD, the systemic side effects of such therapy cannot be ignored. In this study, we used betamethasone retention enemas as a local treatment for eight patients with refractory and/or severe intestinal GVHD. Six of the eight patients showed improvement of diarrhea and/or abdominal pain, with a reduction in the stage of GVHD. When treatment with betamethasone enemas was continued for 10 to 27 days in the 6 responding patients, no severe toxicity was observed. One patient failed to respond to treatment and another could not tolerate the enemas. Despite some uncertainty regarding the indications and duration of treatment, betamethasone enemas seem to be a potential alternative method for the management of intestinal GVHD.

Administration, Topical↗

PubMed2004

The effect of the combination of calcipotriol and betamethasone dipropionate versus both monotherapies on epidermal proliferation, keratinization and T-cell subsets in chronic plaque psoriasis.

Several reports have indicated that the combination of calcipotriol ointment and potent or ultrapotent corticosteroids are more effective and better tolerated, as compared to the monotherapies. The aim of the present study was to find out the effect of combination of calcipotriol ointment once daily and betamethasone dipropionate ointment once daily vs. the effect of twice-daily applications of each of the two treatments as monotherapy during a four-week treatment period. Seven patients with chronic plaque psoriasis were included for treatment with the three treatment schedules. Biopsies were taken before treatment and after four weeks of treatment, and markers for epidermal proliferation (Ki-67) and epidermal differentiation (keratin-10) were studied using a quantitative image analysis, and T-cell subsets in epidermis and dermis (CD4, CD8, CD25, CD45RO, CD45RA, CD94, CD161, and CD2) were studied using immunohistochemical scoring. The most impressive clinical result was reached with the combination. Calcipotriol proved to have a major effect on the proliferation marker Ki-67 and differentiation marker keratin-10, whereas the effect on T-cell subsets was more selective with major reductions of CD45RO(+) and CD8(+) T cells. In contrast, the effect of betamethasone dipropionate on the epidermis was restricted to a normalization of differentiation with a highly significant increase of keratin-10 positive epidermal surface without a significant effect on Ki-67 positive nuclei, and the effect on T-cell subsets was restricted to a reduction of natural killer T-cell receptors designated by CD94 and CD161 in the epidermis. The combination of the two treatments did not affect the proliferation marker Ki-67 and keratinization marker keratin-10, beyond the effect of calcipotriol monotherapy. However, the combination had a profound effect on, virtually, all T-cell subsets, beyond the effect of the monotherapies. It is concluded that the action spectra of calcipotriol and betamethasone on the psoriatic plaque are different and that the combination has effects on T-cell subsets, beyond the addition of the effects of monotherapies.

Anti-Inflammatory Agents↗

PubMed1986

Effects of betamethasone on serum iodothyronines and thyroid hormone-binding proteins in Graves' disease.

The influence of betamethasone on iodothyronines and their binding proteins in serum was studied in 18 patients with Graves' disease. Betamethasone, 6 mg daily, was given orally for 5 days. Serum triiodothyronine (T3) concentration decreased, reverse triiodothyronine increased, while thyroxine (T4) and thyroid-stimulating hormone were unchanged. Thyroxine-binding globulin (TBG) decreased and thyroxine-binding prealbumin increased. In accordance with the decrease in TBG, the in vitro T3 uptake increased and out of the indirect measures of the free thyroid hormones, the free T4 index increased and the free T3 index decreased. We suggest that the decrease in serum T3 during betamethasone administration supports the view of glucocorticoids being beneficial as additional treatment in some patients with thyrotoxic crisis.

Adult↗

PubMed1990

The effects of dexamethasone, betamethasone, flunixin and phenylbutazone on bovine natural-killer-cell cytotoxicity.

A series of in-vitro experiments was performed utilizing the ability of bovine peripheral-blood mononuclear cells (PBMC) to induce lysis of Madin-Darby bovine kidney (MDBK) cells infected with bovine herpesvirus 1 (BHV1), in an antibody-independent natural-killer(NK)-cell cytotoxic assay. The effects of dexamethasone (dexamethasone sodium phosphate), betamethasone (betamethasone sodium phosphate), flunixin (flunixin meglumine) and phenylbutazone on this NK cytolysis were studied using concentrations of the drugs ranging from well below to well above those normally attained in plasma at recommended therapeutic doses. All four drugs inhibited NK activity. For each agent a minimum inhibitory concentration (MIC50) required to inhibit NK activity by approximately 50% was calculated. For dexamethasone, betamethasone and flunixin the MIC50 was lower after a 24-h pre-incubation of PBMC with each drug, although a marked inhibition was seen when the drug was only present during the 5-h NK assay itself. In contrast the MIC50 for phenylbutazone rose after a 24-h pre-incubation with PBMC.

Animals↗

PubMed1985

Effect of betamethasone on the dual reaction to anti-human IgE in man: influence of time interval between administration of drug and anti-IgE.

The influence of the time interval between administration of a glucocorticoid, betamethasone, and anti-IgE on the effect of the drug on the early and late phase response (LPR) to anti-IgE was examined in 38 volunteers in a randomized controlled study. The immediate flare and wheal responses to intradermally (i.d.) injected anti-IgE were inhibited by approximately 20 and 30% respectively by a 10 day i.d. pretreatment period with repeated 50 micrograms doses (total 300 micrograms) of betamethasone (P less than 0.01), whereas responses to histamine were not influenced. A single i.d. injection of 50 micrograms betamethasone 24 h prior to anti-IgE challenge attenuated the wheal response (P less than 0.05), whereas injection of the drug 2 h prior to and together with anti-IgE had no influence on the early response. Corresponding LPRs were reduced approximately 30% throughout the observation period of 1-24 h (P less than 0.01). Injecting the drug i.d. 30 min following anti-IgE challenge had no significant influence on the total observation period (1-24 h) of the LPR but antagonized the LPR by 35% at 6-24 h (P less than 0.01). It is concluded that glucocorticoids inhibit IgE-dependent LPRs. When extending the topical pretreatment period with the compounds also the early part of the allergic reaction is attenuated.

Adolescent↗

PubMed1998

Fetal growth retardation, particularly within lymphoid organs, following repeated maternal injections of betamethasone in sheep.

OBJECTIVE: To examine the effect of single or repeated injections of maternally administered corticosteroids on fetal growth in sheep. METHODS: Forty-six date-mated singleton gestation ewes were allocated at random to one of 3 groups: a single, or repeated injections of betamethasone, or a control group which received saline. On days 125 (preterm) or 145 (term) caesarean section delivery was performed. After lambs were killed, measures of size and weight were recorded. Data were analysed using Fishers Exact test and the Student's t-test. RESULTS: Significant betamethasone dose dependent reductions in body and organ weights and biometry were found at preterm and term gestational ages (p < 0.05). There was little catch up growth in those in whom delivery was delayed until term. Thymus, spleen and liver were particularly targeted. CONCLUSION: Repeated injections of betamethasone to the pregnant ewe cause significant reductions in fetal growth with little evidence of catch up by term. The effect of repeated maternal injections of corticosteroids in human pregnancy will await the results of randomized controlled trails.

Animals↗

PubMed2006

Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo.

BACKGROUND: Treatment of vitiligo is a challenge. Steroids are known to be effective but are associated with serious adverse effects. Many uncontrolled studies have shown calcipotriol to be a promising therapeutic modality in vitiligo. OBJECTIVE: To conduct a randomized trial to evaluate the effect of topical calcipotriol ointment (0.005%) and betamethasone dipropionate (0.05%) cream, given alone or in combination, in treatment of localized vitiligo. METHODS: Forty-nine patients with vitiligo affecting 5% of their skin were recruited. Patients were randomized into three groups. Group I patients were treated with betamethasone dipropionate (0.05%) cream twice daily. Group II patients were treated with calcipotriol ointment (0.005%) twice daily, and group III with betamethasone dipropionate (0.05%) in the morning and calcipotriol (0.005%) in the evening. RESULTS: Forty-five patients completed the study period of 3 months with 15 patients in each group. No patient achieved excellent (> 75%) pigmentation. Marked (50% to 75%) repigmentation was observed in 2 (13.3%), 1 (6.7%) and 4 (26.7%) patients in groups I, II and III, respectively. Moderate (25-50%) repigmentation was observed in 7 (46.7%), 5 (33.3%) and 7 (46.7%) patients in groups I, II and III, respectively. Patients with < 25% pigmentation were termed as minimal pigmentation or no response. The mean time for initial pigmentation to appear was 9.04 +/- 2.0 weeks in group I, 10.18 +/- 1.6 weeks in group II and 5.17 +/- 2.4 weeks in group III (P < 0.01). The acquired pigmentation in the lesions was more stable in group III as compared with patients in groups II and I (P < 0.01). Side-effects in the form of atrophy and lesional burning sensations were more common in group I when compared with groups II and III (P < 0.05). CONCLUSION: Combined therapy appeared to give a significantly faster onset of repigmentation along with better stability of the achieved pigmentation and with lesser number of side-effects.

Administration, Cutaneous↗

PubMed1997

Antenatal corticosteroid therapy and fetal behaviour: a randomised study of the effects of betamethasone and dexamethasone.

OBJECTIVES: To compare the effects of maternal betamethasone and dexamethasone administration on fetal behaviour and fetal heart rate variation. DESIGN: A prospective randomised study of 60 women at increased risk of preterm delivery. OUTCOME MEASURES: Fetal heart rate and its variation, the incidence of fetal body and breathing movements. SETTING: Obstetric unit, University Hospital, Utrecht, The Netherlands. RESULTS: Following maternal betamethasone administration (day 2), fetal heart rate variation was reduced by 19% and fetal body and breathing movements by 49% and 85%, respectively. After dexamethasone treatment there was a significant increase in short term fetal heart rate variation (24%) on day 1. All values returned to baseline on day 4, indicating that no fetal deterioration had occurred during the course of the study period. CONCLUSION: Betamethasone, with probably the greater beneficial effect, has more effects on fetal behaviour and fetal heart rate variation than dexamethasone. When assessing fetal condition, due account needs to be taken of these effects.

Betamethasone↗

PubMed1998

Haematological effects of betamethasone treatment in late pregnancy.

To assess the maternal haematological effects of betamethasone administered in late pregnancy, an automated full blood count was performed before and daily for 5 days after betamethasone in 25 women with a singleton pregnancy between 23 and 33 weeks' gestation. From a mean (+/- SD) baseline level of 11.0+/-2.2 x 10(9)/L, the total white cell count increased significantly to 13.2+/-2.9 x 10(9)/L and 13.5+/-3.1 x 10(9)/L on the first and second day after treatment respectively, returning to baseline on day 3 (p<0.0001, ANOVA). These changes represented a mean increase in the neutrophil count of 35% and a mean decrease in the lymphocyte count of 23%. While there was considerable intersubject variation in the extent of the changes, this study has quantified the leucocytosis induced by betamethasone in late pregnancy, information that may assist with the clinical evaluation of a woman at risk of preterm delivery.

Adult↗

PubMedDate not supplied

Effect of betamethasone and exercise on equine carpal joints with osteochondral fragments.

Osteochondral fragments were created arthroscopically on the distal aspect of both radial carpal bones in 12 horses. On day 14 after surgery, one middle carpal joint of each horse was injected with 2.5 mL Betavet Soluspan (3.9 mg betamethasone sodium phosphate and 12 mg betamethasone acetate per milliliter) and the contralateral joint was injected with 2.5 mL saline as a control. Intra-articular treatments were repeated on day 35. On day 17, six horses began exercising 5 days per week on a high-speed treadmill. The other six horses were kept in box stalls throughout the study as nonexercised controls. On day 56, all horses were examined clinically and radiographically and then were euthanatized. Samples were obtained for histological, histochemical, and biochemical evaluation. Mild lameness was observed in five of the six exercised horses at day 56; four horses were lame in the control limb and one horse was lame in the treated limb. Of the five nonexercised horses evaluated for lameness, two were lame in the control limb, two were lame in the treated limb, and one was lame in both the control and the treated limb. No differences were noted on radiographs or palpation of steroid treated limbs versus control limbs. Firm reattachment of the osteochondral fragment to the radial carpal bone occurred in all but three joints. Gross cartilage damage was not different between steroid-treated joints and joints injected with saline. Histologically, there were no significant detrimental effects of beta-methasone with or without exercise, but there was a tendency for more pathological change in treated joints. No significant difference in the water content or uronic acid concentration was detected between treated and control joints. Intra-articular betamethasone administration in this carpal chip model was not associated with any significant detrimental effects in either rested or exercised horses.

Animals↗

PubMed1975

Betamethasone 17-valerate in childhood asthma. A double-blind crossover trial in children not taking other corticosteroid therapy.

A double-blind crossover trial of Betamethasone 17-Valerate steroid aerosol compared with placebo was carried out on 18 children with severe intermittent or chronic asthma. Seventeen of the 18 children showed a clinically obvious improvement on the active drug. The remaining child was unable to use the inhaler properly. In 14 children the response was dramatic. Improvement was shown at home by a reduction in the number of asthmatic symptoms, improvement in twice daily peak flow rates and by a lowered intake of sympathomimetic tablets. At monthly clinic visits, improvement was shown by chest examination, weight gain and by detailed respiratory function tests. By each of these criteria for improvement the benefit of Betamethasone 17-Valerate over the placebo was highly significant. There were no side effects attributable to the therapy and no evidence, as judged by short tetracosactrin tests, of adrenal suppression resulting from the drug. Betamethasone 17-Valerate appears to be a safe and effective therapy in children with severe asthma.

Adolescent↗

PubMed1997

Comparison of the efficacy of diclofenac and betamethasone following strabismus surgery.

AIMS: To compare the relative antiinflammatory potency and safety of topical diclofenac-gentamicin with betamethasone-neomycin following strabismus surgery. METHODS: A single centre, single observer, prospective, randomised, and double masked clinical trial of 25 children undergoing bilateral symmetrical horizontal strabismus surgery was carried out. One eye received diclofenac-gentamicin and the contralateral eye received betamethasone-neomycin; both treatments were instilled four times a day for 4 weeks postoperatively. Ocular inflammation was assessed at 1 and 4 weeks postoperatively, objectively by comparison with a photographic chart and subjectively by questionnaire. RESULTS: There was no statistically significant difference in the rate of resolution of the inflammatory response between each group at both visits. CONCLUSION: Diclofenac appears to be as effective as betamethasone in controlling postoperative inflammation following strabismus surgery and may offer a safer alternative to the use of topical steroids.

Anti-Bacterial Agents↗

PubMed2001

Treatment of psoriasis with a new combination of calcipotriol and betamethasone dipropionate: a flow cytometric study.

BACKGROUND: Calcipotriol and corticosteroids are established topical antipsoriatics. Previous studies have shown that combined therapy with calcipotriol and betamethasone dipropionate was more effective than monotherapy. In the present study, a recently developed combination product of calcipotriol and betamethasone dipropionate was compared with both monotherapies and the vehicle. METHODS: Twenty-five psoriatic patients were treated twice daily with the combination product, monotherapy or vehicle during 4 weeks. Skin biopsies, taken before and after treatment, were analysed using a multi-parameter flow cytometric method. Parameters of inflammation (vimentin-positive cells), normal differentiation (keratin-10-positive cells) and proliferation (cells in SG(2)M-phase) were assessed. RESULTS: Flow cytometric analysis showed that the combination product turned out to be more effective in reducing inflammation compared with the other treatments. Restoration of normal differentiation was more advanced in patients treated with the combination product or betamethasone dipropionate compared to the vehicle. The highest number of normally differentiated cells was seen after use of the combination product. All treatments, except for the vehicle, decreased hyperproliferation. CONCLUSIONS This study shows that the combination product is a valuable new approach to the treatment of psoriasis.

Adult↗

PubMed1991

Effects of maternal bilateral adrenalectomy and betamethasone administration on fetal rat encephalic development.

The present study examined the effects of maternal bilateral adrenalectomy and betamethasone treatment on fetal encephalic development, in terms of fetal body weight, brain weight, DNA, protein and lipid content and morphological development. Both influenced the developmental time patterns of fetal brain and cerebellum. Fetuses of adrenalectomized rats had decreased body weights, whereas brain weight was not affected. Maternal adrenalectomy produces in fetal brain a decreased number of cells and increased cell size, while betamethasone treatment of adrenalectomized rats increased cell number, which was not different from control values; cell size remained lower than in control fetuses. Lipid content was increased in the fetuses of betamethasone-treated rats. In terms of morphological development, laminated structures (hippocampus and brain and cerebellar cortex) were the ones most affected.

Adrenalectomy↗

PubMedDate not supplied

Effect of betamethasone on the fetal heart rate pattern assessed by computerized cardiotocography in normal twin pregnancies.

The effects of corticosteroids, given for enhancement of fetal lung maturation, on fetal heart rate (FHR) are controversial and may decrease its variability. FHR patterns were analyzed by computerized cardiotocography in 46 fetuses from 23 normal dichorionic twin pregnancies on days 0, 1 and 4-7 while the mothers received four intramuscular injections of 3 mg betamethasone sodium and 3 mg betamethasone acetate within 48 h to enhance fetal lung maturation. Compared with pretreatment values, FHR showed a decrease in long- and short-term variations; other parameters, e.g. the number of fetal movements, remained unchanged. However, decreased FHR variation was followed by an increase in the acceleration rate after maternal administration of betamethasone. These modifications were transient and should not lead to unnecessary anxiety or intervention in otherwise normal fetuses.

Betamethasone↗