A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.

The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

Identification of the metabolites of erythro-9-(2-hydroxy-3-nonyl)hypoxanthine from laboratory animals.

After administration of erythro-9-(2-hydroxy-3-nonyl)hypoxanthine, eight compounds were isolated from the urine of rats, dogs, and monkeys. All of the drug metabolites were modified on the nonyl side chain. The oxidatively degraded metabolites included an alcohol (9-(2,8-dihydroxy-3-nonyl)hypoxanthine), the corresponding ketone (erythro-9-(2-hydroxy-8-keto-3-nonyl)hypoxanthine), and three carboxylic acids [erythro-6-hydroxy-5-(9- hypoxanthyl ) hepanoic acid, erythro-7-hydroxy-6-(9- hypoxanthyl )octanoic acid, and erythro-8-hydroxy-7-(9- hypoxanthyl )nonanoic acid]. Glucuronide conjugates of the unchanged drug and the alcohol metabolite were also found. The alcohol, ketone, and nonanoic acid metabolites were produced by all three species. Only the rat produced the shorter chain acid derivatives and no glucuronides. The monkey excreted both glucuronides, while dogs formed one glucuronide conjugate, that of the parent drug.