Lege Artis Medicinae

[Halogen addition and steroid effect]

NAGY Nikoletta, KEMÉNY Lajos

APRIL 22, 2011

Lege Artis Medicinae - 2011;21(04)

[Among locally administered anti-inflammatory drugs used in dermatology, steroids are among the most commonly applied ones. In everyday practice, choosing the right local steroid preparation is not easy, since more than 50 different local steroid preparations with at least 30 different active ingredients are available. The choice of the local steroid preparation depends on a number of aspescts. It is recommended to apply local steroid preparations that, besides having a strong effect, also have favourable side effect profiles. Moreover, it is subservient to apply local steroids that penetrate deeply into the skin, but have minimal systemic absorption, therefore do not inhibit significantly the hypothalamicpituitary- adrenal axis if administered locally. These characteristics of local steroid preparations are determined by chemical modifications at various positions on the steroid-frame. In this study, we examined the different types of chemical modifications, and the relationship between halogen addition and the characteristics of steroid preparations. We compared the local steroid preparations using the data of previous clinical trials. Regarding the efficacy, safety, tolerability and the risk/benefit ratio, the halogenated steroid preparations were overall superior to nonhalogeneted ones. Among the halogenated preparations, the fluticasone propionate, the mometasone furoate and clobetasol propionate were proved to be the most suitable locally administered, very potent or super potent ones.]

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