Flutikason – hudläkemedel
Klassificering: AATC kod: D07AC17
Sammanfattning
Det finns enstaka studier med analys av könsskillnader vad gäller effekt av flutikason kräm/salva men resultaten är motstridiga och den kliniska relevansen oklar.
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.
Additional information
Pharmacokinetics and dosing
No studies with a clinically relevant sex analysis regarding pharmacokinetics and dosing of fluticasone have been found.
Effects
A placebo controlled study in patients with atopic eczema (156 male, 216 female) a reduction in the risk of flare development and lengthening of the time to the first flare after application of fluticasone 0.05% cream was demonstrated and subgroup analyses showed no difference between men and women regarding the primary efficacy parameter [1].
In an another placebo controlled study (29 boys, 46 girls) assessing the efficacy and safety of fluticasone 0.005% ointment in the maintenance treatment of children with atopic dermatitis, a highly statistically significant treatment effect was observed in girls (p < 0.001) [2]. The authors suggested that compliance factors and treatment preferences (i.e. perhaps boys do not like ointment-based formulations) may have influenced the results. However, the total number of boys was small and there was an imbalance in ratio of boys/girls between treatment groups; 13 (33%): 26 (67%) in the fluticasone group and 16 (44%):20 (56%) respectively in the placebo group.
Adverse effects
Both men and women have been included in most of the safety studies of topical fluticasone cream/ointment. However, no analysis of sex differences have been found and sex-divided data is lacking [2, 3].
Reproductive health issues
Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).
Försäljning på recept
Fler kvinnor än män hämtade ut kräm innehållande flutikason (ATC-kod D07AC17) på recept i Sverige år 2015, totalt 1 560 kvinnor och 1 288 män. Det motsvarar 0,32 respektive 0,26 personer per tusen invånare. Andelen som hämtade ut läkemedel var högst i åldersgruppen 65-69 år hos kvinnor och 70-74 år hos män. Totalt sett var kräm innehållande flutikason 1,2 gånger vanligare hos kvinnor [4].
Uppdaterat: 2019-02-26
Litteratursökningsdatum: 2016-12-13
Referenser
- Hanifin J, Gupta AK, Rajagopalan R. Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Br J Dermatol. 2002;147:528-37. PubMed
- Glazenburg EJ, Wolkerstorfer A, Gerretsen AL, Mulder PG, Oranje AP. Efficacy and safety of fluticasone propionate 0005% ointment in the long-term maintenance treatment of children with atopic dermatitis: differences between boys and girls?. Pediatr Allergy Immunol. 2009;20:59-66. PubMed
- Roeder A, Schaller M, Schäfer-Korting M, Korting HC. Safety and efficacy of fluticasone propionate in the topical treatment of skin diseases. Skin Pharmacol Physiol. 2005;18:3-11. PubMed
- Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-12-27.] Socialstyrelsens statistikdatabas
Faktagranskat av: Mia von Euler
Godkänt av: Karin Schenck-Gustafsson