A Comparison of Single and Multiple Applications of Halcinonide Cream

Abstract

A double-blind paired comparison was made of once daily and three times daily regimens of 0.1% halcinonide cream in 149 patients with atopic dermatitis and 194 with psoriasis. In a simultaneously conducted study once daily application of 0.1% halcinonide was compared to the cream base alone (placebo) in 48 patients with atopic dermatitis and 78 with psoriasis. Results show that a once daily regimen can be an effective treatment in both conditions, and can be recommended as a starting regimen in certain circumstances such as the treatment of young children or pregnant women, or where long-term treatment is likely. The three times daily regimen, however, was superior overall, and is still recommended as the treatment of choice, at least in severe psoriasis.

A Thorough Systematic Review of Treatments for Atopic Eczema

“…Hoare and colleagues reviewed the 3 trials comparing once-daily vs more frequent use of the same topical corticosteroids. [2][3][4] In none of the trials were more frequent applications superior to once-daily applications. These observations should be kept in mind for cost and compliance considerations.…”

Guidelines for management of atopic dermatitis

“…However, when using topical corticosteroids of lower ranks or changing to drugs without corticosteroids, it is necessary to confirm that there is no recurrence by changing to an intermittent pattern such as alternate‐day or once‐a‐day application. With regards to topical corticosteroids at the rank higher than the strong class, there is not a significant difference between twice‐a‐day application and once‐a‐day application in curative effects after 3 weeks (evidence level II: by one or more randomized controlled trials) 31,32 . Considering the fact that side‐effects diminish as the application times decrease, it is preferable to apply twice a day in an acute exacerbation to sedate the inflammation quickly and to apply once a day after improvement of the eruption (recommendation grade A: strongly recommended to perform).…”

Frequency of application of topical corticosteroids: an overview

“…For the treatment of dermatitis, recent studies revealed no difference between once and twice daily application or slight differences which are probably not of clinical significance. 20,21 Both were paired comparison investigations with one study showing no difference except for a relatively more rapid onset of action. 18 Both treatments significantly reduced all clinical features equally, but the clearance rate was significantly higher with the twice daily regimen.…”