Clobetasol Propionate for Psoriasis: Are Ointments Really More Potent?
June 2006 | Volume 5 | Issue 6 | Case Reports | 527 | Copyright © June 2006
Lindsey Warino MS, Rajesh Balkrishnan PhD, Steven R. Feldman MD PhD
Background: Clobetasol propionate is the most common topical therapy used for psoriasis in the US. Conventional dermatologic
wisdom is that ointment preparations provide the highest potency (due to their occlusive nature and moisturizing
ability) and are best suited for psoriasis. However, patients often find application of ointment to be messy, raising concerns
about both short-term and long-term adherence to treatment. This article reviews the current literature and assesses the relative
potency of clobetasol propionate ointment compared to other clobetasol propionate preparations in the treatment of
psoriasis. Relevant literature was identified by PubMed and Google searches. We included studies of psoriasis that reported
the percentage of subjects that achieved desired efficacy endpoints, as well as studies that reported the subjects’ mean change
in symptoms from baseline. We excluded studies conducted before 1980 and those that allowed concomitant treatments.
Observations: Efficacy rates ranged from 17% to 80% for the different vehicles: ointment, solution, foam, cream, lotion,
shampoo, and emollient.
Conclusions: Clobetasol propionate is a very effective treatment for psoriasis. Ointment preparations have similar efficacy to
other preparations in clinical trial situations. In clinical practice, a situation in which patient preferences are more likely to
affect compliance, it may be best to choose whichever vehicle patients find preferable.