Dosing

  • For the acute stage of eczema daily application of Cutivate is recommended
  • New evidence guides us to apply Cutivate twice a week to maintain control of eczema. This reduces the potential of side effects as well as the cost of therapy

Efficacy

  • Although not indicated for use on children in Canada, studies have shown that once daily application is safe and effective in children with atopic eczema.
  • This novel topical steroid is both potent as well as having a good safety profile in that it has an improved topical/systemic activity ratio. In other words its potency gives efficacy with no or little risk of HPA axis suppression.

[Wolkerstorfer A et al JAAD 1998;39:226-31]

Compliance

  • Daily application in the acute phase and thereafter twice weekly maintaince should help with compliance
  • Cutivate being a potent topical corticosteroid works more quickly than the weaker products which generally improves compliance
  • Cosmetic elegance has been shown to be superior to Elocom, Westcort, Lidex and Kenalog.

[Hadzija W. et al Cutis Vol 57. No 2s Feb. 1996]

Side Effects, Safety and Risks

  • Approx 270 million packs sold since 1990 in US
  • From 1992 ~ July ‘04, five (5) spontaneous reports of skin atrophy.
  • Cutivate cream 0.05% cream appears safe for the treatment of severe eczema for up to 4 weeks in children of 3 months and older.

[Friedlander SF et al JAAD 2002:46:387-93]

  • No skin atrophy showed after 8 weeks of use compared with placebo.

[Dykes PJ Clinical and Experimental Dermatology 1996;21:180-184]

Cost of Treatment

  • Cost of this drug is in line with other potent topical corticosteroids.
  • Cost effectiveness is seen if effective clinical response is realized. The utilization of a twice a week regimen significantly reduces costs.
Potent Potent Moderately Potent Non-steroidal Non-steroidal
Cutivate Fluticasone propionate (1x daily) Elocom Mometasone furoate (1x daily) Eumovate Clobetasone butyrate (2x daily) Protopic Tacrolimus (2x daily) Elidel Pimecrolimus (2x daily)
$7.70 $14 $21.56 $83.07 $67.20

Treatment for 14 days. Cost is for 1 gram per treatment.