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Painless thyroiditis induced by the cessation of betamethasone.

We describe the first reported case of painless thyroiditis induced by an abrupt cessation of betamethasone. A 53-year-old woman experienced transient thyrotoxicosis after the abrupt cessation of celestamine, a mixture of betamethasone and chlorpheniramine. Since neither TSH receptor- nor thyroid stimulating-antibodies were negative, and thyroid scintigram did not show the thyroid gland, she was diagnosed as having painless thyroiditis. Fourteen months after the onset of thyrotoxicosis, serum TSH was detectable without hypothyroidism. We speculate that reduction in betamethasone may be one of the triggers of painless thyroiditis.

Anti-Allergic Agents↗

Serum estriol level during treatment with betamethasone in the last trimester of human pregnancy.

A comparison was made between betamethasone disodiumphosphate/betamethasone acetate (Celeston) and betamethasone disodiumphosphate (Celestona) in antenatally prophylactic treatment of respiratory distress syndrome syndrome (RDS). Altogether 65 pregnant women in the last trimester of pregnancy were treated with the first-mentioned drug and 62 with the second. The RDS-preventive effect was the same in the two groups. Celeston has a much longer depressive effect on the level of plasma estriol than has Celestona. Use of this drug, betamethasone disodiumphosphate, is therefore recommended in the prophylaxis against RDS.

Betamethasone↗

Anti-inflammatory effects of betamethasone phosphate, dexamethasone phosphate and indomethacin on rabbit ocular inflammation induced by bovine serum albumin.

Following the induction of immunogenic uveitis betamethasone and dexamethasone reduced conjunctiva and iris hyperemia and aqueous flare. Indomethacin reduced iris hyperemia, but potentiated conjunctival hyperemia. All three agents inhibited the increase in the protein content of the aqueous that follows induction of immunogenic uveitis. Betamethasone was slightly more potent than dexamethasone and indomethacin. White cell entry into the aqueous was inhibited by betamethasone and dexamethasone. Paradoxically, however, indomethacin significantly potentiated the number of polymorphonuclear leukocytes (PMNs) entering the aqueous. The anti-inflammatory effects of steroidal agents may be due to the inhibition of the release of arachidonic acid (AA) which is a precursor of both lipoxygenase and cyclooxygenase products. The potentiation of the PMN response by indomethacin in immunogenic uveitis may be due to an inhibition of cyclooxygenase product formation and a facilitation of lipoxygenase products (which are potent chemotactic agents) from AA.

Animals↗

Comparative double-blind trial of intra-articular injections of two long-acting forms of betamethasone.

Two injectable betamethasone preparations, betamethasone dipropionate/betamethasone phosphate and betamethasone acetate/betamethasone phosphate were compared in a controlled trial on 22 "matched patient pairs" with rheumatic diseases. The two preparations were injected intra-articularly in knee joints affected by active synovitis. The time until onset of action and the duration of clinically adequate anti-inflammatory effect were recorded. All injections produced clinically significant effects. The interval before recurrence of symptoms varied from 2 days to more than 3 months. The dipropionate form showed statistically significantly longer duration of action. No difference was noted in the time until onset of action. Local side effects were not observed. The double-blind method of clinical evaluation proved useful in comparing duration of action between long-acting corticosteroids.

Adult↗

Effects of betamethasone, sulindac and quinacrine drugs on the inflammatory neoangiogenesis response induced by polyurethane sponge implanted in mouse.

In this study, we showed the effect of the betamethasone, sulindac and quinacrine alone or combined, on the inflammatory angiogenesis promoted by polyurethane sponge on mice. The main finding reported here is that the formation of new blood vessels was strongly inhibited by low concentration of betamethasone, sulindac or quinacrine, whether alone or in combination. It is known that steroidal anti-inflammatory drugs inhibit the enzymes required for the production of prostaglandins through a nuclear glucocorticoid receptor (GR) mediated mechanism. This mechanism may occur in endothelial cells as well. Considering that activity of cyclo-oxigenases 1 and 2 is inhibited by sulindac, and that these enzymes are located in the stromal tissue, we propose that the anti-angiogenic effect of these agents may occur via inhibition of both COX isoforms. On the other hand, quinacrine inhibited PLA2 activity, and we propose here that the anti-angiogenic effect occurs via inhibition of the enzyme PLA2. The potentiated effect of the association of betamethasone, sulindac and quinacrine may have some therapeutic benefit in the control of pathological angiogenesis. Further studies are required to validate these propositions.

Animals↗

The effect of betamethasone on fetal biophysical activities and Doppler velocimetry of umbilical and middle cerebral arteries.

OBJECTIVE: Preliminary reports suggest that antenatal steroid administration may confound the assessment of fetal well-being by suppressing biophysical activities, consequently drug-induced effects could prompt unwarranted delivery of premature fetuses. The purpose of this study was to examine the effect of antenatal betamethasone administration on fetal biophysical activities and Doppler flow indices of the umbilical and middle cerebral circulation. METHODS: Forty women at risk of premature delivery between 27-32 weeks gestation (mean 30.2 weeks) received two consecutive doses of intramuscular betamethasone, 24 hours apart. Ultrasonographic observations of fetal behavior for 30 minute periods and Doppler examination of the umbilical and cerebral arteries were performed prior to (0 hours), 48 hours after, and 96 hours after administration of the first dose. To account for fetal circadian rhythms and maternal prandial status, all examinations were carefully timed and performed between 1-4 pm. Analysis of Variance, chi-square test and Fisher's Exact test were used for statistical analysis, as appropriate. RESULTS: Nine patients were excluded from analysis due to delivery prior to completion of all examinations. Number of breathing episodes as well as total breathing time at 48 hours decreased by 83.0% (p<0.01) and 90.4% (p<0.01), respectively, at 48 hours in comparison to baseline. Fetal limb and trunk movements decreased by 53.2% (p<0.01) and 48.6% (p<0.01), respectively. Amniotic fluid volume and fetal tone were normal in all patients. At 48 hours, 14 of 31 fetuses and 4 of 31 fetuses had a biophysical profile score of 6/8 and 4/8, respectively, in comparison to 0 of 31 and 0 of 31 at 0 hours (p<0.05 and p<0.001, respectively). All parameters returned to baseline values at 96 h. Pulsatility indices of umbilical and middle cerebral arteries remained unchanged at 48 hours and 96 hours (p=NS). CONCLUSIONS: Betamethasone induces a profound, albeit transient, suppression of fetal breathing, limb and trunk movements, resulting in decreased biophysical profile scores. Awareness of this drug-induced effect might prevent unnecessary iatrogenic delivery of preterm fetuses.

Adult↗

[UV-B comb versus betamethasone solution in scalp psoriasis].

BACKGROUND: The aim of the study was to assess the effectiveness of a UV-B-comb on scalp psoriasis versus betamethasone valerate solution. MATERIAL AND METHODS: Of 44 adult patients with scalp psoriasis, 22 were treated with a dermalight 80 psoracomb and 22 with betamethasone valerate solution, five times a week for three weeks. RESULTS: No difference in effect was found at the end of treatment. Two weeks after end of treatment a higher proportion of patients treated with UV-B-comb (7/22) had remained in remission than those treated with betamethasone valerate solution (3/22; p < 0.05). INTERPRETATION: Treatment with a UV-B-comb offers a good alternative to topical corticosteroids for patients with scalp psoriasis.

Administration, Topical↗

[Prevention of respiratory distress syndrome with betamethasone. Preliminary communication].

A controlled trial of antepartum glucocorticoid treatment for prevention of respiratory distress syndrome in premature infants was carried out. 37 mothers, in whom premature delivery threatened between 28 and 37 weeks of gestation, were given intramuscular injections 8-12 mg of betamethasone as well as medication inhibiting uterine activity and strict bedrest to delay premature delivery for at least 24 to 48 hours. In comparison with a control group of 16 mothers, who received tocolytic and sedative medication and were on strict bedrest and another control group of 42 untreated patients, there was no difference in the 3 groups concerning the incidence of respiratory distress syndrome in premature infants, but there was a lower perinatal mortality rate of respiratory distress syndrome in the betamethasone treated group, than in the controls, possibly due to a milder course of respiratory distress syndrome disease by accelerating functional maturation of the fetal lung with betamethasone.

Apgar Score↗

[Betamethasone Sodium Phosphate Reference Standard (Control 001) of National Institute of Health Sciences].

The raw material of betamethasone sodium phosphate was examined for the preparation of the "Betamethasone Sodium Phosphate Reference Standard (Control 001)". The analytical data obtained were: melting point, 207.2 degrees C; pH, 8.1; optical rotation, [alpha]D20 = +104.4 degrees; UV spectrum, lambda max of 242 nm and specific absorbance in water at 242 nm = 272.9; IR spectrum, specific absorptions at 3386.9, 1721.7, 1663.3, 1620.4, 1605.0, 1094.3, 985.8, 889.8 cm-1; free phosphoric acid, 0.3%; thin-layer chromatography, one impurity was detected until 200 micrograms; high-performance liquid chromatography, total amount of impurities estimated to be less than 0.5%; water, 9.2%. Based on the above results, the raw material was authorized as the Betamethasone Sodium Phosphate Reference Standard (Control 001) of the National Institute of Health Sciences.

Betamethasone↗

[Betamethasone Sodium Phosphate Reference Standard (Control 881) of National Institute of Hygienic Sciences].

The raw material of betamethasone sodium phosphate was examined for preparation of the "Betamethasone Sodium Phosphate Reference Standard". Analytical results for the sample were as follows: pH 7.90; optical rotation + 100.5 degrees; IR spectrum the same as USP Reference Standard of Betamethasone Sodium Phosphate; TLC indicated no impurities, but 5 kinds of impurities were detected in small amounts by HPLC; water content 14.7%; assay 100.2% by HPLC. Based on the above results, this raw material was authorized to be the Reference Standard of the National Institute of Hygienic Sciences.

Betamethasone↗

Betamethasone: A dermatological clinical evaluation.

The purpose of this study was to determine under carefully controlled clinical conditions the relative anti-inflammatory and anti-pruritic action of betamethasone as compared with prednisone and a placebo. A total of 130 consecutive patients with atopic dermatitis, primary irritant dermatitis, nummular eczema, allergic eczematous contact dermatitis, sweat retention, seborrheic dermatitis and pruritus were selected for study. Under the conditions of this clinical trial, the samples indicated a difference in anti-inflammatory and anti-pruritic response to the therapeutic agents used. The difference between betamethasone and the placebo was highly significant, and the difference in these measured responses was studied on the basis of a careful evaluation and statistically. The result of this study corroborates statistically our clinical impression regarding the therapeutic effect of betamethasone.

Adrenal Cortex Hormones↗

In vitro diffusion cell design and validation. II. Temperature, agitation and membrane effects on betamethasone 17-valerate permeation.

An in vitro permeation cell has been designed and validated for use in monitoring the transmembrane permeation of betamethasone 17-valerate. The design utilizes common laboratory equipment and incorporates as many beneficial features as possible from other designs. The importance of fully validating the hydrodynamic performance of the cell prior to experimentation is stressed. The cell was validated by monitoring the diffusion of betamethasone 17-valerate in isopropyl myristate solution into purified isopropyl myristate receptor phase at different temperatures, different agitation rates and through different synthetic and biological membranes. The results of the hydrodynamic validation agree with data from other researchers and show that the permeation cell is adequately sensitive to these experimental parameters. The results of the membrane evaluation allow appropriate selection of the barrier material for representative transdermal experiments to be conducted. While human and porcine stratum corneum/epidermis are similar in diffusive properties, hairless mouse skin appears to be the most convenient animal membrane for these studies. Although silicone and cellulose membranes appear to be useful in this application, porous filter membranes and egg-shell membranes are insufficiently discriminatory to betamethasone 17-valerate diffusion to provide useful in vitro permeation data.

Animals↗

Betamethasone in tetanus patients: an evaluation of its effect on the mortality and morbidity.

The effect of betamethasone on the outcome in moderate to severe tetanus was studied in a randomised, double blind, placebo controlled study in 22 patients. The mortality rate was reduced by 36.1% with the addition of corticosteroids to the regime of treatment. Betamethasone did not alter the duration of intensive care in those requiring it, but reduced the need for tracheostomy and ventilation. The mean daily dose of diazepam required was not significantly different between the two groups and there was no increase in the incidence of infections in the betamethasone group.

Adult↗

A randomized controlled clinical trial assessing the effect of betamethasone valerate 0.12% foam on the short-term treatment of stasis dermatitis.

BACKGROUND: There are no published studies examining either the effectiveness of topical steroids in the treatment of stasis dermatitis or indicating what steroid strength or duration of treatment is optimal to treat this common condition. OBJECTIVE: To investigate the efficacy of twice-daily application of the topical steroid betamethasone valerate 0.12% foam for the treatment of stasis dermatitis. DESIGN: 42-day randomized, double-blinded, vehicle-controlled, pilot study. SETTINGS: Outpatient dermatology clinic at a university-affiliated clinic. SUBJECTS: 19 subjects, mean age of 73, with mild to moderate bilateral stasis dermatitis. INTERVENTION: Twice-daily application of betamethasone valerate 0.12% foam versus vehicle foam to bilateral randomly assigned lower legs for 28 days with follow-up to day 42. MAIN OUTCOME MEASURES: The primary clinical endpoints were the mean change in erythema, scale, swelling, petechiae, post-inflammatory hyperpigmentation, and self-reported pruritus, assessed on a 5-point Likert scale (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe). Secondary endpoints were changes in health related quality of life (HRQL) using the EuroQol-5D (EQ-5D) utility score and visual analog scale (VAS) and the Dermatology Life Quality Index (DLQI). RESULTS: Although there was no overall difference between the foam and vehicle-treated leg at days 14 and 28, the steroid-treated leg, but not the vehicle-treated leg, showed statistical improvement over baseline. Improvement in the steroid-treated leg was statistically better than vehicle at days 14 and 28 in terms of erythema (P < .05) and petechiae (P < .05). Improvement in VAS was notable at days 14 (7.1%), 28 (9.7%), and 42 (9.6%) (P < .001). Similarly, there was a statistically significant improvement in the DLQI compared to baseline on visit days 14 (188.9%) and 28 (126.1%) (P < .001). CONCLUSIONS: This study suggests that betamethasone valerate 0.12% foam is an effective and well-tolerated short-term treatment of stasis dermatitis, but that higher potency steroids may be needed to achieve better efficacy. Furthermore, these results are the first to suggest that the application of effective topical anti-inflammatory therapy can lead to improvement in HRQL.

Administration, Topical↗

[Betamethasone injection in chronic hypertrophic laryngitis].

OBJECTIVE: To evaluate the curative effects of Betamethasone for treatment of voice hoarseness of chronic hypertrophic laryngitis. METHODS: From July, 2001 to December, 2002, 48 cases of the chronic hypertrophic laryngitis had been treated by injected of Betamethasone at vocal cords. Fundamental frequency (FO), jitter, shimmer, normalized noise energy (NNE) acoustics' parameters were tested and paired t test were calculated. The voice quality of 1 month and 6 months after treatment were synthetically graded, one-way ANOVA and the DANCAN test were conducted. RESULTS: Eight cases were injected under surface anesthesia with indirect laryngoscopy at the clinic service. Thirty-eight cases were injected under general anesthesias with micro-laryngoscopes. After six months following up, the voice hoarseness was obviously improved, the congestion or oedema of vocal cord was lessened, and the voice quality was improved as well. The results of F0, jitter, shimmer, NNE acoustics' parameters after treatment 6 months showed: 8 of 48 cases (17.39%) had treatment effect, 22 out of 48 cases (47.83%) had obviously effect, 10 out of 48 cases (21.74%) had cured. The total effectiveness had reached 86.96% (40 of 48 cases). Six of 48 cases (13.04%) was failure. CONCLUSION: Vocal cord injection of Betamethasone for the hoarseness of chronic hypertrophic laryngitis is an effective treatment method.

Adult↗

Conjunctival necrosis due to subconjunctival injection of betamethasone in treatment of graft rejection after penetrating keratoplasty.

A rare side effect of betamethasone applied subconjunctivally is described. A 51-year-old man who had undergone penetrating keratoplasty in his left eye 2 months previously developed graft rejection and was treated by subconjunctival injection of betamethasone. Within 2 weeks, the patient complained of conjunctival hyperemia and irritation. Biomicroscopic examination revealed conjunctival and subconjunctival necrosis with white necrotic tissue at the subconjunctival corticosteroid injection site. Simple debridement and primary wound closure of the involved area resulted in complete healing. Ophthalmologists should be aware that subconjunctival injection of betamethasone may cause conjunctival necrosis.

Betamethasone↗

Calcipotriol-betamethasone ointment versus calcipotriol ointment in the treatment of psoriasis vulgaris.

Of 17 patients (10 men and 7 women) with psoriasis vulgaris, aged between 12 and 59 years, included in this study, 4 patients were excluded (3 because of a treatment follow-up irregularity and 1 due to severe irritation). Thirteen patients completed the 6-week treatment course where each patient was instructed to apply calcipotriol-betamethasone ointment on the right side and calcipotriol ointment on the left side. The treatment effect was assessed according to the psoriasis area severity index (PASI) changes, and complete blood count and serum calcium was done prior to and at the end of the treatment. Results showed that both sides had improved by 92.3%, with a marked reduction in the mean PASI (from 11.5 to 2.2); a better reduction was observed in the right side during the second and third visits. A marked improvement to complete clearance was seen in 84.6% in calcipotriol-betamethasone side and 76.9% in calcipotriol alone. Mild irritation was reported in the left side in 15.4% which was tolerated with the continuation of treatment application. No telangiectasia or atrophy was observed on the right side. In conclusion, calcipotriol-betamethasone may be recommended in the early weeks of the treatment of psoriasis vulgaris, and it is helpful in psoriasis patients with irritation to calcipotriol alone.

Adolescent↗

[Early effect of non-surgical treatment using betamethasone valerate ointment for phimosis in childhood].

We evaluated the early efficacy of non-surgical treatment using 0.07% betamethasone valerate ointment on, 34 boys with phimosis between January 2001 and June 2005. Patients were treated with 0.07% betamethasone valerate ointment applied to the distal aspect of the prepuce every other day for 2-6 weeks. During the treatment period, patients were instructed to retract the foreskin to penis root without overstraining. The overall success rate was 94.1% and therapeutic effects were observed in 58.8% of the patients in two weeks. There were no medical side effects. Treatment using betamethasone valerate ointment is very effective, easy and safe. We recommend this treatment for patients with phimosis and/or those with recurring balanoposthitis.

Anti-Inflammatory Agents↗