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A double-blind, controlled study was performed in which eight investigators treated a total of 180 psoriasis patients with either betamethasone dipropionate cream or fluocinolone acetonide cream for four weeks. Betamethasone dipropionate cream was clearly superior to the control preparation in the degree of improvement effected and rapidity of action.
The aim of the study was to determine a possible interaction between a corticosteroid (betamethasone) and vecuronium, a nondepolarizing muscle relaxant. The authors studied 20 patients, ASA I-II, aged 20-54, both sexes, scheduled for abdominal surgery. Mechanomyographic and clinical evaluation by single twitch and TOF stimulation of the ulnar nerve at the wrist and measurement of the concomitant abductor pollicis muscle was applied. The onset time of vecuronium after a single bolus dose of 0.08 mg/kg, duration of action to 10% single twitch recovery, duration of continuous infusion of 0.4-0.5 micrograms/kg/min of vecuronium started at 10% single twitch recovery, and the effects of 0.1 mg/kg betamethasone administration 10 min after continuous infusion were evaluated. The recovery rate of vecuronium after stopping infusion at 10% recovery was also evaluated. Corticosteroids may interact with non-depolarizing muscle relaxants both in prejunctional and postjunctional acetylcholine receptors by several mechanisms of action.
Investigations were carried out on 24 pregnant white New Zealand rabbits and their 210 fetuses. Eight pregnant rabbits received intravenous injections of carnitine on the 25th, 26th and 27th day of pregnancy, in doses of 80 mg/kg/24 hours. Eight other pregnant rabbits were given carnitine in the same manner and betamethasone intramuscularly on the 25th and 26th day of pregnancy in doses of 0.1 mg/kg/24 hours. Eight control pregnant rabbits received intravenous and intramuscular injections of normal saline. In all the groups caesarean section was performed on the 28th day of pregnancy. The contents of lecithin and sphingomyelin in lung homogenates of fetuses and in amniotic fluid were determined by thin-layer chromatography. The lungs of the fetuses were subjected to morphological studies in light and in electron microscopes. The studies proved that carnitine given during pregnancy accelerated biochemical and morphological maturation of fetal rabbit lungs. However, administration of carnitine in combination with betamethasone does not provide better effect than the administration of carnitine alone.
Quinacrine produces obstruction of the region of the uterine tube by its fibroblastic granulomatous action. Factors such as the Zn++ and Cu++ content of tubal tissue, as well as the use of anti-prostaglandins, potentialise this action. Two groups of patients were evaluated in this study: Group A--95 women. 180 mg of quinacrine +0.6 mg of betamethasone were inserted into the uterine cavity, on the basis of two insertions separated by a one month interval. Two pregnancies were found by the end of the 2nd year, the percentage failure rate being 2.2 and the Pearl index 0.58. Group B--129 women. 216 mg of quinacrine +1.2 mg of betamethasone were inserted into the uterine cavity, on the basis of two insertions separated by a one month interval. Two pregnancies were found by the end of the 1st year, the percentage failure rate being 0.59 and the Pearl index 0.54. Iatrogenic adverse reactions associated with quinacrine only were not seen in either of these two study groups. None of the pregnancies was ectopic.
The efficacy, safety, and tolerability of the mid-potency corticosteroid, fluticasone propionate ointment, 0.005%, were compared with those of a high-potency corticosteroid, betamethasone-17,21-dipropionate ointment, 0.05%, in a twelve-week randomized, double-blind, parallel-group, multicenter study of seventy-four patients with moderate-to-severe psoriasis. Efficacy was evaluated for four weeks; safety was evaluated over a twelve-week period. Fluticasone ointment, 0.005%, was not significantly different from betamethasone ointment, 0.05%, at day 15 (P = 0.147), at the end of treatment analysis (P = 0.245), or at day 29 (P = 0.154). Neither medication resulted in any abnormal laboratory values over the twelve-week study period, including plasma cortisol levels. Both medications were well tolerated.
Investigators conducted two double-blind, randomized, parallel-group trials to compare the efficacy of fluticasone propionate cream, 0.05%, and betamethasone valerate cream, 0.1%, in the treatment of moderate-to-severe psoriasis. Up to 100 gm/week of the study medication was applied topically to affected areas of the body twice daily for up to four consecutive weeks. Efficacy and safety were evaluated after seven, fourteen, twenty-one, and twenty-eight days of treatment. The data from the participating sites show that fluticasone propionate cream, 0.05%, was as efficacious as betamethasone valerate cream. Investigators found no statistically significant differences between the two products by any of the three variables used to gauge efficacy (P > 0.05). Drug-related adverse events were few and mild. These findings support the conclusion that fluticasone propionate cream, 0.05%, is effective and well tolerated when used to treat moderate-to-severe psoriasis and is comparable to a widely used midpotency topical steroid.
OBJECTIVES: Heat emitted during the process of inflammation can be visualized by means of dynamic telethermography (DDT). In the case of sinusitis, it is possible to verify the efficacy of an anti-inflammatory treatment such as betamethasone. PATIENTS AND METHODS: Ten adult ambulatory patients with sinusitis were treated with 2 tablets of betamethasone (Celestene) 2 mg daily for 10 days without concomitant medications. DDT images were obtained on day 0, day 2, day 3, day 5 and day 10. A color chart indicated differences in temperature according to the selected sensitivity. Computer analysis of the images was then obtained. Clinical assessment of symptoms and tolerance were recorded at the same time-points as the DDt images. RESULTS: The effect of treatment was beneficial in all patients since cure of sinusitis was achieved in 5, with marked improvement in 4 others and fair improvement in 1. Pain was significantly reduced on day 10 compared with day 0 (Friedman's test p < 0.0001). There was a simultaneous reduction of sinusitis associated signs: rhinorrhea, lacrimation, photophobia and cutaneous hyperesthesia as well as of general signs. On the DDT images, right-sinus to right-side and left-sinus to left-side ratios both showed a significant decrease between day 0 and day 10 from 41.00 +/- 14.07 to 7.90 +/- 7.22 (ANOVA p < 0.0001) and from 30.70 +/- 5.20 +/- 6.49 (ANOVA p < 0.0001) respectively. DISCUSSION: Whereas in animal pharmacology inflammation can be evaluated by any number of objective methods, only a very few are applicable to clinical situations. Powerful computer image analysis may prove useful in establishing nature and severity based inflammation reduction standards. CONCLUSION: These preliminary findings demonstrated that in most cases single agent therapy provides adequate and rapid control of clinical and thermographic signs of acute sinusitis. Computer analysis corraborates clinical findings and thermogram interpretations.
The Peyronie's disease or Induratio Penis Plastica, represents one of the most controversial and uncertain points of the modern andrology, since its real etiology is still disputable. Consequently also the non-surgical therapy results as still confused and variable as shown in the considerable number of drugs utilized till now. Our study takes into consideration the injection therapy, by the use of the Betamethasone (corticosteroid), and it tries to explain, how it is possible, the real efficacy of drug versus placebo. The randomized study includes 30 patients. The valuation of the results has been effected in reference to three parameters: disappearance of pain, decrease of plaque volume and consistency of 50%, decrease subjective penile curvature. The data obtained show no significant differences between group A (treated with Betamethasone) and group B (treated with placebo). At twelve months of mean follow-up the pain at erection disappeared in 66.6% of the patients of group A, in 53.3% of the patients of group B. The curvature diminished in 20% of the patients of group A and in 26.6% of the patients of group B. A decrease in plaque volume and consistency was noted in 40% of the patients of group A and in 40% of the patients of group B. The data show that probably the clinical results of the therapy is to refer to a mechanical effect of injected volume and not to the drug action itself.
Betamethasone valerate aerosol, given in doses of up to 800 microgram per day, was compared with placebo in a double-blind trial involving 23 patients with oral lichen planus. The majority of patients receiving the active aerosol noted improvement within the first 2 weeks of treatment and at 8 weeks the lesions had almost cleared; in contrast, only 2 patients on placebo showed slight improvement over the same time period. The results suggest that this form of treatment is an effective and acceptable method of controlling the discomfort due to oral lichen planus, especially where minor erosions are present.
The effect of serial dilution of betamethasone-17-valerate (Betnovate ointment) in Unguentum Merck was investigated using a single application blanching assay in 10 subjects and high performance liquid chromatography. There was no statistically significant difference between any of the diluted formulations with regard to blanching potential. Chemical stability was maintained following a 1:32 dilution for 2 months and 1:4 dilution for 5 months at least, after storage at room temperature.
10 patients with sub-total villous atrophy were given the topical corticosteroids betamethasone valerate or clobetasone butyrate for a period of 4 months whilst continuing on a normal diet. 5 patients improved symptomatically while red cell folate, urinary xylose and faecal fat excretion also improved. Brush border enzymes increased in patients treated with higher dosages of each drug. Enterocyte height increased and intra-epithelial lymphocytes were significantly decreased although overall morphological appearances remained indistinguishable from untreated coeliac disease. Suppression of the pituitary adrenal axis occurred in 8 patients and there did not appear to be useful separation of topical from systemic activity. These compounds offer no advantage over prednisolone in non-responsive coeliac disease.
The effect of concentration and occlusion time on the ability of Betnovate cream (betamethasone 17-valerate 0.1%) to produce skin blanching was assessed. Generally, increased concentration or occlusion time produce an increase in the degree of blanching observed, however, a plateau stage is eventually reached where no further increase of blanching occurs.
Evaluation of cutaneous vasoconstriction after applications of varying duration of topical corticoids on the flexor surfaces of the forearms of 20 patients with intact skin shows a significantly faster blanching effect with diflucortolone valerate ointment than with fluocinolone acetonide and betamethasone valerate ointments. Furthermore, the test shows that even for a highly active preparation, such as the diflucortolone valerate ointment, an application time of less than 3 h only exceptionally leads to vasoconstriction in the healthy skin.
A randomized, double-blind, left-right comparative study was carried out to compare the value of hydrocortisone 17-butyrate with that of betamethasone 17-valerate in the treatment of eczematous skin disorders. In a series of 23 patients with such disorders, no differences between the two preparations was demonstrated with regard to effectiveness.
Tibicorten, a new fluorine-substituted corticosteroid for topical application, was compared with betamethasone valerate in a double-blind investigation with left-right examinations. There appeared to be no significant difference between the results obtained with each substance in the treatment of patients with acute or chronic eczema or with psoriasis.
In a double-blind within-patient clinical trial in psoriasis, budesonide 0.025% ointment has been shown to be at least as efficient as betamethasone-17-valerate 0.1% ointment. A lower concentration of budesonide ointment, 0.01%, was used for 4 weeks of maintenance treatment. This concentration controlled residual symptoms well in a majority of the patients, thirty-two in number.
The clinical efficacy of 0.05% diflorasone diacetate applied once daily, for eczematous dermatoses, was compared with the twice daily application of betamethasone valerate. Both agents were supplied as ointments. Sixty patients were randomized to one of the two treatment regimens. The investigators were unaware of the regimen used. Evaluations were made at 1 and at 3 weeks. There were no statistically significant differences in eight parameters studied at any time during the study. No side-effects were reported.
A new preparation for treatment of psoriasis of the scalp, containing desoxymethasone 0.25%, salicylic acid 1% and polyol-fatty esters in ethanolic solution (Ibaril) was tested in patients with psoriasis of the scalp. In a double-blind study comprising forty patients there was a significant difference in favour of this solution in comparison with betamethasone valerate solution, 0.1% (Betnovat) after 2 weeks of treatment.