Eumovate (Clobetasone Butyrate) Patient Profile, Dosing Efficacy, Compliance and Cost

Patient Profile

Suitable Candidates

• Patients with a steroid responsive skin condition who don’t require a potent or very potent topical corticosteroid

Unsuitable Candidates

• Patients with a known hypersensitivity to the topical corticosteroid or to the vehicle
• Patients with mycobacterial, fungal, and/or viral infections
• Patients with scabies or pediculosis
• Patients with chronic ulcers
• Avoid treatment of rosacea and perioral dermatitis. Topical corticosteroids may initially provide improvement, but severe rebound flare-up may occur upon discontinuance.
• Should not be used for the treatment of acne.
• Should not be used for routine gingivitis. This should be treated by removing the local causative factors and improving oral hygiene.

Dosing

• suitable for the treatment of mild-to-moderate AD.
• unique gentle cream base with moisturizing properties.
• best for short-term treatment of extensive dermatoses.
• best used on the trunk and extremities.
• safer for short-term use on thin skin; it is less effective on thicker skin.
• should be applied 2-3 times daily according to the severity of condition.
• should be used to bring flare-ups of eczema under control.
• can be used intermittently long-term, e.g., weekends only, to prevent relapses.
• should be used in combination with moisturizers.
• can be used in combination with other drugs.

Frequency of Application:

• Apply thinly 2-3 times per day (according to the severity of the condition) to the affected area and rub gently into the skin. Maximum adult dosage should not exceed 100 g/week.

[CPS. The Canadian Drug Reference for Health Professionals. Ottawa: Canadian Pharmaceutical Association (2003).]

General Guidelines for Eumovate® Cream vs. Ointment

Efficacy

• • Clobetasone butyrate 0.05% cream with its moisturizing emollient base is reported to provide better healing properties than hydrocortisone 1% cream. Its high glycerol content promotes skin hydration and protects and moisturizes the skin.

[J Dermatol Treat. 2001 Dec;12(4):191-7.]

• has no demonstrated potential for skin thinning vs. 1% hydrocortisone.
  [GSK product monograph]
• has negligible systemic absorption and effect on HOP axis function.
  [GSK product monograph]
• has minimal side effects even in children under 2.
  [GSK product monograph]
• has a high glycerol content which promotes skin hydration and absorption.
  [J Dermatol Treat. 2001 Dec; 12(4):191-7.]
• contains dimethicone to protect and moisturize the skin.
  [J Dermatol Treat. 2001 Dec; 12(4):191-7.]
• The emollient base used for Eumovate® cream offers better healing properties than 1% hydrocortisone.
  [J Dermatol Treat. 2001 Dec; 12(4):191-7.]

Compliance

• Reasons for treatment failure in atopic eczema:
  • failure to use the topical corticosteroid due to fear of real or imagined side-effects
  • under prescribing/failure to use sufficient quantity
  • failure to renew prescription in time.

• It is very important that patients/caregivers understand the safety and potential side effects for moderate potency topical corticosteroids such as Eumovate®. Misconceptions about commonly prescribed topical corticosteroid preparations among parents/caregivers include:
  • • 44% graded hydrocortisone as a potent steroid.
    • 42% did not grade betamethasone valerate 0.1% as potent.
    • 29% graded clobetasone butyrate 0.05% (Eumovate®) as potent.
    • 12% graded clobetasone butyrate 0.05% (Eumovate®) as weak.

[Beattie PE, Lewis-Jones MS. Parental knowledge of topical therapies in the treatment of atopic dermatitis. Clin Exp Dermatol. 2003 Sep;28(5):549-53.]

• Patient education on topical steroids is clearly needed

Cost of Treatment