Dr. Hepburn's fellowship was supported in part by grants from University Physicians, Inc., and Schering Laboratories.
A Reappraisal of Topical Steroid Potency
Article first published online: 20 MAR 2008
Volume 13, Issue 3, pages 239–245, May 1996
How to Cite
Hepburn, D. J., Aeling, J. L. and Weston, W. L. (1996), A Reappraisal of Topical Steroid Potency. Pediatric Dermatology, 13: 239–245. doi: 10.1111/j.1525-1470.1996.tb01211.x
- Issue published online: 20 MAR 2008
- Article first published online: 20 MAR 2008
Abstract: Topical corticosteroids have been one of the cornerstones of dermatologic treatment for nearly 40 years. At present the most widely used topical steroid ranking system is the vasoconstrictor assay. To determine whether this is a satisfactory measure of the agents’ potency in clinical settings, we examined rankings from the published literature achieved by four different methods: vasoconstriction, clinical outcome, therapeutic index (a ratio of efficacy to systemic safety), and cost, safety, and efficacy. Overall clinical outcome (efficacy) rankings in this study corresponded in only 11 (62%) of 17 topical steroid preparations with the expected vasoconstrictor rankings. The therapeutic index rankings did not correspond with the clinical outcome (33%) or the vasoconstrictor assay (33%) rankings. It was difficult to compare studies because of lack of standardization of clinical trials. We urge that topical steroid rankings not be based solely on vasoconstrictor assays, and that a standard method be developed for clinical trials of the drugs to allow for comparison among preparations.