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The topical corticosteroid classification called into question: towards a new approach.
Philippe Humbert1, Alexandre Guichard
1Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC INSERM 1431), Besançon University Hospital, Besançon, France; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.
Experimental Dermatology
|February 25, 2015
Summary
The 1962 vasoconstrictor assay for topical corticosteroids is outdated. Potency does not always correlate with anti-inflammatory effects, necessitating a new classification system for better therapeutic targeting and reduced side effects.
Area of Science:
- Dermatology
- Pharmacology
Background:
- The vasoconstrictor assay, established in 1962, was an early method to assess topical corticosteroid potency.
- This assay measures vasoconstriction, a surrogate marker for corticosteroid penetration and local effect.
Discussion:
- Modern understanding reveals that strong vasoconstrictor effects do not consistently predict strong anti-inflammatory activity.
- The evolving knowledge in corticosteroid pharmacology necessitates a re-evaluation of existing classification systems.
- Over-reliance on the vasoconstrictor assay may lead to suboptimal therapeutic choices and patient dissatisfaction.
Key Insights:
- The vasoconstrictor assay is an insufficient measure of topical corticosteroid efficacy.
- A disconnect exists between vasoconstrictive potency and actual anti-inflammatory therapeutic outcomes.
- A new classification system is required to align corticosteroid potency with specific therapeutic targets.
Outlook:
- Developing a novel classification system based on anti-inflammatory efficacy and therapeutic application is crucial.
- This revised classification aims to optimize treatment selection for various dermatological conditions.
- The goal is to enhance therapeutic efficiency, minimize adverse effects, and combat corticophobia.
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