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PubMed1993

Etoposide, doxorubicin, cyclophosphamide and high-dose betamethasone (EACB) as outpatient salvage therapy for refractory multiple myeloma.

Fifty-six patients with refractory multiple myeloma were treated with intermittent courses of etoposide, doxorubicin, cyclophosphamide and high-dose betamethasone (EACB) every 4th week. The overall response rate was 30%. Durable remissions exceeding 1 year were obtained in 12 of the 17 responding patients. A significant prolongation of the survival time was found for responding patients (median 13 months) compared to those patients who did not respond (median 9 months) to EACB therapy (p = 0.01). A low frequency of neutropenic fever episodes was noted compared to other salvage treatment regimens. The EACB regimen was usually well tolerated and could be administered safely on an out-patient basis. This regimen might be an alternative especially for elderly patients unresponsive to initial therapy.

Actuarial Analysis↗

PubMed1977

Cord serum lipid and lipoprotein-cholesterol values in normal and betamethasone-treated newborns of varying gestational age.

Cord serum total cholesterol, very low density lipoprotein-, low density lipoprotein-, high density lipoprotein-cholesterol and triglyceride was determined in 30 AGA infants and 35 SGA infants born between the larger than or equal to 37th less than or equal to 42th week of gestation and in 26 AGA infants born between the larger than or equal to 33th less than 37th week of gestation. In SGA infants significantly higher VLDL-cholesterol and triglyceride values were found than in AGA infants. In AGA infants less than 37 weeks of gestation total cholesterol, LDL-, and HDL-cholesterol concentrations were higher than in AGA infants larger than or equal to 37 weeks of gestation. In 10 betamethasone-treated AGA infants less than 37 weeks of gestation HDL-cholesterol was higher than in 16 untreated AGA infants less than 37 weeks of gestation.

Betamethasone↗

PubMed2005

Treatment of experimental arthritis with poly(D, L-lactic/glycolic acid) nanoparticles encapsulating betamethasone sodium phosphate.

OBJECTIVE: To examine the therapeutic activity of hydrophilic glucocorticoid encapsulated in PLGA nanoparticles, which have shown slow release and are targeted to inflamed joints after intravenous administration, in experimental arthritis models. METHODS: Betamethasone sodium phosphate (BSP) encapsulated in PLGA nanoparticles with a size of 100-200 nm (PLGA-nanosteroid) was prepared using a modified oil in water emulsion solvent diffusion method with Zn ions and coated with lecithin. Rats with adjuvant arthritis (AA rats) and mice with anti-type II collagen antibody induced arthritis (AbIA mice) were treated intravenously with PLGA-nanosteroid after the initial sign of arthritis. RESULTS: In AA rats, a 30% decrease in paw inflammation was obtained in 1 day and maintained for 1 week with a single injection of 100 mug of PLGA-nanosteroid. Soft x ray examination 7 days after this treatment showed decreased soft tissue swelling. Moreover, the PLGA-nanosteroid was also highly effective in AbIA mice. A single injection of 30 mug of the PLGA-nanosteroid resulted in almost complete remission of the inflammatory response after 1 week. In contrast, the same dose of free BSP after three administrations only moderately reduced the severity of inflammation. In addition, a histological examination 7 days after the treatment showed a significant decrease of the inflammatory cells in the joints. CONCLUSION: The observed strong therapeutic benefit obtained with PLGA-nanosteroid may be due to the targeting of the inflamed joint and its prolonged release in situ. Targeted drug delivery using a sustained release PLGA-nanosteroid is a successful intervention in experimental arthritis.

Animals↗

PubMed1992

Acyclovir ointment plus topical betamethasone or placebo in first episode disciform keratitis.

Thirty patients with first episode disciform keratitis and with no previous steroid exposure were randomly assigned to double blind treatment with 3% acyclovir ointment and 0.1% betamethasone (Betnesol) drops or acyclovir ointment and matching placebo. In the steroid group 14 of the 15 patients healed in a mean time of 21.8 days. In the placebo group eight of the 13 patients healed in a mean time of 34.5 days. The difference in mean healing time between the two groups was significant (p < 0.05). The cumulative rate of healing was also quicker in the steroid group when compared with the placebo group (p < 0.001). Other clinical parameters improved more favourably in the combination treatment group. Four patients, two in either group, experienced a mild transient punctate epitheliopathy, but no other serious adverse effects were noted. There has been no significant difference in the recurrence rate between the two groups after a mean follow-up period of approximately 3 years.

Acyclovir↗

PubMed1979

Effect of betamethasone on pressure-volume relationship of fetal rhesus monkey lung.

We have investigated the acceleration of fetal lung maturity following glucocorticoid administration. Air-filling of saline-filling pressure-volume curves were obtained on fetal rhesus monkey lungs after treatment with betamethasone. With air filling there was a marked increase in the total lung capacity (ml air/g at 40 cmH2O) in the treated animals. By normalizing the curves and plotting volume as a percent maximal volume, we examined the shape of deflation curves, a common functional measure of surfactant activity. We found little difference in the shapes between control and steroid-treated animals. With saline filling there was also a similar increase in the lung capacity. As surface tension has a negligible effect on saline pressure-volume curves, we conclude that the primary functional effect of glucocorticoids on the fetal lung may not be an alteration of surface forces. Rather the glucocorticoids seem to accelerate maturity more by increasing lung compliance through structural changes that allow the lung to contain more air for equivalent transpulmonary pressures or pressure changes. This may occur either by increasing the distensibility of already inflatable alveoli or by recruiting new units.

Animals↗

PubMed1990

Antenatal betamethasone dose effects in preterm rabbits studied at 27 days gestation.

Pregnant rabbits received bethamethasone (0.05, 0.2, 0.4, or 0.5 mg.kg-1.day-1) or vehicle control for 2 days before delivery of fetuses at 27 days gestation to evaluate dose-related effects on surfactant pool sizes with and without ventilation, pressure-volume measurements, lung protein leaks, and precursor incorporation into lung saturated phosphatidylcholine (PC). Alveolar wash-saturated PC pool sizes in betamethasone-exposed fetuses were less than in controls (P less than 0.01). At higher doses, total lung saturated PC also decreased (P less than 0.01). Maximal lung volumes on pressure-volume loops were larger than controls only at the 0.4 mg.kg-1.day-1 dose (P less than 0.05). The larger maximal volumes, despite decreased saturated PC pools, indicated increased responsiveness of the steroid-treated lungs to the smaller saturated PC pool sizes. Vascular-to-alveolar iodinated albumin leak decreased with steroid treatment independently of dose (P less than 0.01). No consistent pattern of increased precursor incorporation into saturated PC by lung slices was seen. Our results indicate that, in preterm rabbits exposed to a range of maternal corticosteroid doses, the beneficial lung maturational effect of structural alterations with increased responses to endogenous saturated PC pools was maximal even at the lowest dose.

Animals↗

PubMed2002

Dose-related inhibition of proinflammatory cytokine release from neutrophils of the newborn by dexamethasone, betamethasone, and hydrocortisone.

The objective of this study was to determine the doses of dexamethasone (DEX), betamethasone (BET), and hydrocortisone (HC) that effectively inhibit the release of two potent proinflammatory chemokines, interleukin 8 (IL-8) and macrophage inflammatory protein alpha (MIP), from polymorphonuclear neutrophils (PMNs) of the newborn. Human PMNs were isolated from cord blood (n = 18). Chemokines were measured from PMN cell culture supernatants after 18 h of stimulation using tumor necrosis factor (1 ng/ml), with and without pretreatment by DEX (10(-10) to 10(-6) M) versus HC or BET (10(-10) to 10(-5) M). Maximal inhibitions of IL-8 release by BET, DEX, and HC were 97, 91, and 91%, respectively. For MIP, the maximal inhibitions by BET, DEX, and HC were 88, 69, and 70%, respectively. The 50% inhibitory concentrations by DEX, BET, and HC for IL-8 release were 3.4 +/- (SE) 1.6 x 10(-9), 1.8 +/- 7.4 x 10(-8), and 1.8 +/- 0.5 x 10(-7) M, respectively. The 50% inhibitory concentrations by DEX, BET, and HC for MIP release were 1.0 +/- (SE) 0.5 x 10(-8), 3.8 +/- 3.1 x 10(-8), and 4.8 +/- 1.6 x 10(-7) M, respectively. In vitro, these corticosteroids effectively inhibited the release of two structurally different chemokines that are found in the airway lavage fluids of infants developing bronchopulmonary dysplasia. When compared to plasma DEX levels previously reported during the treatment of bronchopulmonary dysplasia, our results suggest that the doses of DEX, and potentially BET, needed to treat chronic lung disease may be more than five to ten times lower than those of current DEX regimens.

Anti-Inflammatory Agents↗

PubMedDate not supplied

Three-year prospective randomized study of incidence of posterior capsule opacification in eyes treated with topical diclofenac and betamethasone.

PURPOSE: To investigate the incidence of posterior capsule opacification (PCO) in eyes treated with diclofenac sodium (DFNa) and betamethasone phosphate (BMS) ophthalmic solutions. METHODS: A total of 200 eyes with silicone intraocular lens implantation were treated with topical agents for 3 months postoperatively. Twenty-six cases of the DFNa group and 34 of the BMS group met the criteria, and the severity of PCO was evaluated after 3 years. RESULTS: The results of axial densitometry by Scheimpflug photography were 27.8 computer-compatible tapes (CCT) in the DFNa-treated group and 32.6 CCT in the BMS-treated group (p = 0.1539). Posterior capsulotomy was performed in 11.5% of the DFNa group and 17.6% of the BMS group (p = 0.8375). The photographic grading of PCO showed no difference. CONCLUSION: The incidence of PCO in eyes treated with DFNa appears to be equal to that after BMS treatment.

Aged↗

PubMed2005

A two-compound product containing calcipotriol and betamethasone dipropionate provides rapid, effective treatment of psoriasis vulgaris regardless of baseline disease severity.

BACKGROUND: A two-compound product containing calcipotriol and betamethasone dipropionate (Daivobet/Dovobet) has been evaluated in a large clinical trial programme, providing a wealth of data on the treatment of psoriasis vulgaris. OBJECTIVE: To determine the effectiveness of the two-compound product in patients with mild, moderate and severe psoriasis vulgaris. METHODS: Data from over 1,534 patients with psoriasis vulgaris who received the two-compound product once daily for at least 4 weeks in four randomised, double-blind studies were pooled. A meta-analysis of the pooled data is presented. Severity of psoriasis at baseline was determined by investigator assessment and Psoriasis Area and Severity Index (PASI) score. RESULTS: For patients with severe disease defined by PASI score (PASI baseline > or = 17), the mean reduction in PASI after up to 4 weeks of treatment was 71.6% compared with 68.9 and 67.2% for those with moderate (PASI baseline 5.1-16.0) and mild disease (PASI baseline < or = 5). Corresponding reductions for investigator-assessed severity were 72.6, 69.1 and 68.7%, respectively. CONCLUSION: Although the meta-analysis of the data from these four studies was performed post hoc, we may conclude that the two-compound product provided highly effective treatment of psoriasis, regardless of the category of baseline disease severity.

Administration, Topical↗

PubMed1990

Single-fiber electromyography for studying the effect of betamethasone on normal neuromuscular junctions in man.

The effects of steroids on normal end-plate in vivo were evaluated in man by using single-fiber electromyography (SFEMG). SFEMG was performed on voluntarily activated extensor digitorium communis muscle under basal conditions and 1 week later an intramuscular injection of 4 mg betamethasone per day was administered for 7 days. Ten patients with low back pain were examined. Steroid therapy did not induce any statistically significant variation either of the mean jitter value or of the percentage of recordings with abnormally high jitter. The results of this study do not give evidence of a direct effect of steroids on normal neuromuscular junction.

Adult↗

PubMed1990

Depletion of hypothalamic growth hormone-releasing hormone by neonatal monosodium glutamate treatment reveals an inhibitory effect of betamethasone on growth hormone secretion in adult rats.

Rats were treated with monosodium glutamate (MSG), 4 mg/g on alternate days for the first 10 days of life, to induce lesions of the arcuate nucleus and destroy the majority of growth hormone-releasing hormone (GHRH) neurones. At 10 weeks of age, control (n = 42) and MSG-treated (n = 36) male rats were used to test the effect of glucocorticoids on growth hormone (GH) secretion. Each treatment group was divided into six study groups to determine the effect of betamethasone (BM), administered either 3 or 20 h prior to sacrifice, alone and in combination with hypoglycaemia (insulin 0.1 U/100 g). BM treatment of male rats was without effect on plasma GH levels in control animals. In contrast, glucocorticoid administered either 3 h before sacrifice or the previous evening significantly reduced circulating GH (p less than 0.001) in MSG-treated animals. The difference in plasma GH response to BM pretreatment in control rats and those with lesions of the arcuate nucleus indicates a hypothalamic action of glucocorticoids, presumably on somatostatin and GHRH neurones. In control animals the effects appear to be counterbalancing, but following destruction of GHRH neurones an uncompensated inhibitory influence was observed. Male MSG-treated rats had lower body weight (-25%) and reduced hypothalamic GHRH (-89%) and pituitary GH content (-69%) compared to male controls. Female rats which had undergone the same neonatal MSG treatment (n = 40) when sacrificed 1 week after their male counterparts showed similar reductions in body weight (-15%), hypothalamic GHRH (-74%), and pituitary GH (-67%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

PubMed1982

Selective inhibition by betamethasone of allergen-induced release of SRS-A from human lung.

Passively sensitized human lung, when incubated with the appropriate allergen, released histamine and slow-reacting substance (SRS-A). Betamethasone sodium phosphate (5-100 microgram/ml), preincubated with the lung overnight, suppressed, in a dose-related manner, the release of SRS-A without having an effect on the release of histamine. Preincubation for only 1 h produced little effect on the release of SRS-A or of histamine. These results may help to explain some of the beneficial effects of glucocorticoids in allergic asthma.

Allergens↗

PubMed1987

Betamethasone modulates the biological function of human polymorphonuclear leukocytes.

We have examined the influence of betamethasone (BT) on cyclic AMP (cAMP) metabolism and lysosomal enzyme release from highly purified (approximately equal to 99%) human polymorphonuclear leukocytes (PMNs). Preincubation (1-24 h) of human PMNs with BT (10(-9)-10(-5) M) had no effect on either cAMP content or on beta-glucuronidase release induced by formyl-containing tripeptide (f-met peptide). Preincubation (16-24 h) of PMNs with BT (10(-8)-10(-7) M) dose-dependently potentiated the cAMP accumulation caused by beta-agonists (isoproterenol), adenosine A2/Ra agonist (NECA), prostaglandin E1 (PGE1) and histamine in PMNs. Similarly, BT potentiated the inhibition of f-met peptide-induced beta-glucuronidase release from human PMNs caused by PGE1 (10(-6) M), histamine (2 X 10(-5) M), NECA (10(-4) M) and isoproterenol (10(-6) M).

Adenylyl Cyclases↗

PubMed1993

Diflorasone diacetate ointment 0.05% versus betamethasone dipropionate ointment 0.05% in moderate-severe plaque-type psoriasis.

We report the results of a 2-week double-blind, parallel clinical trial comparing two superpotent topical glucocorticosteroid ointments, diflorasone diacetate 0.05% and betamethasone dipropionate 0.05%, in psoriatic adults. Both corticosteroid ointments were fast acting and highly efficacious. 40 of the 44 patients who initially enrolled completed the trial. There were no statistically significant differences between the two glucocorticoids with respect to erythema, scaling, induration or the investigator's global evaluation after either 1 or 2 weeks of therapy. The level of patient satisfaction with the efficacy and cosmetic acceptability of these two category I glucocorticoids was similar. No systemic or local adverse reactions were noted.

Administration, Topical↗

PubMed1991

Intermittent corticosteroid maintenance treatment of psoriasis: a double-blind multicenter trial of augmented betamethasone dipropionate ointment in a pulse dose treatment regimen.

Ninety psoriasis patients, who were either completely cleared of or manifested only a minimal presence of disease signs following 3-4 weeks of twice daily treatment with augmented betamethasone dipropionate (ABD) ointment 0.05%, were enrolled in this multicenter, double-blind, placebo-controlled study. The study was designed to determine if an intermittent pulse dose regimen of ABD ointment could safely and effectively maintain a remission disease status when treatment was applied in three consecutive applications 12 h apart, once a week for a maximum treatment period of 6 months. The disease of 60% of the patients in the active treatment group was successfully controlled for 6 months, while 80% of the placebo-treated patients experienced exacerbation of disease signs. No serious local or systemic treatment-related adverse experiences were reported. ABD ointment 0.05%, when applied using the intermittent treatment regimen described here, was shown to be a clinically beneficial and well-tolerated method of long-term (up to 6 months) maintenance therapy for psoriasis patients.

Administration, Topical↗

PubMed2003

Intraocular tissue distribution of betamethasone after intrascleral administration using a non-biodegradable sustained drug delivery device.

PURPOSE: To evaluate the tissue distribution of betamethasone (BM) after implantation of a nonbiodegradable intrascleral implant as a new, controlled intraocular delivery system. METHODS: Nonbiodegradable intrascleral implants designed to release BM for at least 1 month were placed in the sclera of pigmented rabbits. The BM concentrations in the aqueous humor, vitreous, and retina-choroid were determined by high-performance liquid chromatography (HPLC) at 3, 7, 14, and 28 days after implantation. The BM concentrations in three sections of retina-choroid were also investigated. Retinal toxicity was evaluated by electroretinography and histology. RESULT: The BM released from the intrascleral implant in vitro and in vivo showed zero-ordered release profiles for 4 weeks. The BM concentrations in the retina-choroid after placement of the intrascleral implants remained higher than effective concentrations for suppressing various inflammatory processes for at least 28 days. The BM concentrations in the retina-choroid around the implantation site were more than 10 times higher than in the opposite side throughout the study. No substantial toxic reactions were observed by electroretinography or histology. CONCLUSIONS: These findings suggested that the nonbiodegradable intrascleral implant could be a useful drug carrier for intraocular delivery of BM without producing severe retinal toxicity. The intrascleral site may be considered for effective intraocular drug distribution after implantation.

Animals↗

PubMed1976

Percutaneous absorption of betamethasone-17, 21-dipropionate and salicylic acid during the treatment of psoriasis and eczema.

The percutaneous absorption of betamethasone-17, 21-dipropionate and salicylic acid was studied after one and two weeks' treatment of psoriaris and eczema. The treated areas varied between 8 and 41 dm2. No change in the plasma cortisol levels was detectable by the routinely used laboratory method. The treatment gave no detectable salicylate concentrations in plasma.

Administration, Topical↗

PubMed1977

A clinical comparison of betamethasone 17,21-dipropionate and clobetasol propionate creams in dermatology.

In a double-blind investigation, 36 patients suffering from various steroid-reponsive dermatoses were treated twice daily for three weeks either with 0-05% betamethasone 17,21-dipropionate cream or with 0-05% clobetasol propionate cream. Results showed both products to be highly effective in terms of onset of action and efficacy and no statistical differences were found (p greater than 0-1).

Administration, Topical↗