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pubmed papers justification for clobetasone butyrate use

April 16 2012 at 12:18 PM
Jonathan  (Login jonnykent)


Response to Back to basics.

I'd "substituted" clobetasone butyrate (eumovate) to avoid arm wrestling my doctor on the basis of what I read. A quick lok now found:
http://www.cirp.org/library/treatment/phimosis/berdeu1/

which nicely refers to several studies with different agents, whilst the following seems to answer the explicit question I was posing: efficacy of my clobetasone butyrate vs. the "traditional" steroid, from a 2005 paper.

Whilst the method and stats look somewhat dubious [I'm afraid that seems to be the way of 80% of medical papers/ research -- but then I would say that I'm a mathematician-- although i would also quote that in fact the BMJ agreed with me a few years back...] nontheless they do at least allow one to get a little beyond "gut feel"... for lay people like me, but I'm happy to be corrected by a proper professional!


Anyway, from pubmed:
http://www.ncbi.nlm.nih.gov/pubmed/15758802
The abstract copy and pasted:

Highly potent and moderately potent topical steroids are effective in treating phimosis: a prospective randomized study.

Yang SS, Tsai YC, Wu CC, Liu SP, Wang CC.


Source

Department of Urology, En Chu Kong Hospital, Taipei Medical University, Taiwan.


Abstract

PURPOSE:

We report a prospective randomized study comparing the effects of highly potent and moderately potent topical steroids in treating pediatric phimosis.

MATERIALS AND METHODS:

A total of 70 boys 1 to 12 years old with phimosis were randomly assigned to receive topical application of either betamethasone valerate 0.06% (a highly potent steroid) or clobetasone butyrate 0.05% (a moderately potent steroid). Parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroids over the stenotic opening of the prepuce twice daily for 4 weeks, then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 0 to 5. Response to treatment was arbitrarily defined as improvement in the retractibility score of more than 2 points.

RESULTS:

Mean treatment and followup periods were 4.3 and 19.1 weeks, respectively. The response rates in boys treated with betamethasone valerate and clobetasone butyrate were 81.3% and 77.4%, respectively (p = 0.63). Mean retractibility score decreased from 3.9 +/- 1.0 to 1.7 +/- 1.1, and 4.2 +/- 1.0 to 1.9 +/- 1.0 in the betamethasone and clobetasone groups, respectively. Both steroids were effective in all age groups. Pretreatment retractibility score did not affect treatment outcomes. No adverse effect was encountered.

CONCLUSIONS:

Highly potent and moderately potent topical steroids are of comparable effectiveness in treating phimosis. A less potent steroid may be considered first to decrease the risk of the potential adverse effects.

Your thoughts I'd be very interested in, and happy to do some more digging...

 
 Respond to this message   
Response TitleAuthorDate
 Well you have convinced us!Paul B.Apr 16, 2012, 3:49 PM
  ty !JonathanApr 16, 2012, 4:25 PM
   Do not confusePaul B.Apr 17, 2012, 5:43 AM
    Re: Do not confuseJonathanApr 17, 2012, 4:40 PM
     Well now.Paul B.Apr 17, 2012, 11:14 PM
      well nowJonathanApr 18, 2012, 4:26 PM
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