Topical glucocorticoids with improved risk-benefit ratio. Rationale of a new concept.

摘要: Topical glucocorticoids for dermal application were introduced more than 40 years ago and revolutionised the treatment of inflammatory skin diseases. Today these drugs are frequently administered, although systemic local adverse drug reactions, especially atrophy, feared complications their use. This literature review evaluates present state topical glucocorticoid therapy Several attempts have been made to increase safety treatment. With respect conventional compounds, new schedules, as well vehicles, proposed. New derivatives also synthesized, forming novel group nonhalogenated double-ester-type glucocorticoids. Among latter prednicarbate 6-methyl-prednisolone aceponate characterised most thoroughly. According in vivo studies, anti-inflammatory activity is order that betamethasone valerate (a used medium potency glucocorticoid, which obtained by halogenation pregnane nucleus steroid molecule). Furthermore, congeners induce less atrophy glucocorticoids, determined vitro studies. Qualitative quantitative assessment therapeutic effects non-halogenated suggests an increased benefit-to-risk ratio.