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Topical Corticosteroid

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28061. The efficacy of fluticasone propionate aqueous nasal spray for allergic rhinitis and its relationship to topical effects. (Abstract)

The efficacy of fluticasone propionate aqueous nasal spray for allergic rhinitis and its relationship to topical effects. Fluticasone propionate aqueous nasal spray is an intranasal corticosteroid for the treatment of patients with allergic rhinitis. This double-masked, double-dummy, parallel-group study was conducted to confirm that the efficacy of fluticasone propionate nasal spray is attributable to topical rather than systemic effects. A total of 304 patients with documented seasonal (...) fluticasone propionate groups or the placebo group. With few exceptions, oral fluticasone propionate (5 mg or 10 mg) was not significantly different from placebo on any measures of efficacy. These findings indicate that the efficacy of fluticasone propionate nasal spray (200 micrograms once daily) in the treatment of allergic rhinitis results from direct topical effects rather than from indirect effects after systemic absorption.

1997 Clinical therapeutics Controlled trial quality: uncertain

28062. Effect of topical applications of budesonide and azelastine on nasal symptoms, eosinophil count and mediator release in atopic patients after nasal allergen challenge during the pollen season. (Abstract)

Effect of topical applications of budesonide and azelastine on nasal symptoms, eosinophil count and mediator release in atopic patients after nasal allergen challenge during the pollen season. We studied the activity of a topical form of a corticosteroid (budesonide) and an antihistamine (azelastine) in the treatment of seasonal allergic rhinitis by including an assessment of mediator concentrations and the percentage of eosinophils in the nasal secretions before and after the treatment. Nasal (...) significant increases in histamine, tryptase and leukotriene C4 (LTC4) concentrations in nasal secretions were evidenced immediately after NAC. Budesonide showed a strong (p<0.05) decrease in infiltration and activation of eosinophils, and on tryptase and LTC4 release after NAC. These effects (not for LTC4) lasted at least for 1 week after therapy. Azelastine is a powerful topical antihistamine, while budesonide appears to be a potent long-acting anti-inflammatory agent.

1997 International archives of allergy and immunology Controlled trial quality: uncertain

28063. Clobetasol propionate followed by calcipotriol is superior to calcipotriol alone in topical treatment of psoriasis. (Abstract)

Clobetasol propionate followed by calcipotriol is superior to calcipotriol alone in topical treatment of psoriasis. Although potent, topical corticosteroids offer effective and rapid healing of psoriatic lesions. Their long term use is limited because of the risk of side effects. Calcipotriol is safe for long-term treatment, but its initial efficacy is lower than with topical corticosteroids.To investigate whether 2 weeks of treatment with clobetasol propionate 0.05% ointment bd followed by 4

1998 Journal of the European Academy of Dermatology and Venereology : JEADV Controlled trial quality: uncertain

28064. Comparison of calcipotriol monotherapy and a combination of calcipotriol and betamethasone valerate after 2 weeks' treatment with calcipotriol in the topical therapy of psoriasis vulgaris: a multicentre, double-blind, randomized study. (Abstract)

associated with the long-term use of topical corticosteroids (atrophy and rebound) as well as the irritation associated with calcipotriol. (...) Comparison of calcipotriol monotherapy and a combination of calcipotriol and betamethasone valerate after 2 weeks' treatment with calcipotriol in the topical therapy of psoriasis vulgaris: a multicentre, double-blind, randomized study. A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol and betamethasone valerate after previous treatment with calcipotriol alone was more effective than the continuation of the monotherapy

1998 The British journal of dermatology Controlled trial quality: uncertain

28065. IL-13 mRNA and immunoreactivity in allergen-induced rhinitis: comparison with IL-4 expression and modulation by topical glucocorticoid therapy. Full Text available with Trip Pro

IL-13 mRNA and immunoreactivity in allergen-induced rhinitis: comparison with IL-4 expression and modulation by topical glucocorticoid therapy. The allergen-induced late nasal response (LNR) is associated with high expression of interleukin-4 (IL-4) and IL-5 messenger RNA (mRNA) in the nasal mucosa, suggesting a role for Th2-type cytokines in the development of the LNR. Moreover, topical corticosteroid-mediated inhibition of the LNR is accompanied by inhibition of IL-4, but not IL-5, mRNA (...) expression, IL-13 shares a number of functions with IL-4, including IgE switching and vascular cell adhesion molecule-1 (VCAM-1) upregulation. We investigated the expression of IL-13 mRNA and immunoreactivity in nasal biopsies from 10 normal subjects and 20 subjects with allergic rhinitis. IL-4 mRNA expression was examined in the same subjects. The allergic rhinitis patients were randomized to receive a 6-wk treatment with either topical fluticasone propionate (n = 10) or placebo (n = 10) nasal spray

1997 American journal of respiratory cell and molecular biology Controlled trial quality: uncertain

28066. Th-2 type cytokine receptors in allergic rhinitis and in response to topical steroids. (Abstract)

Th-2 type cytokine receptors in allergic rhinitis and in response to topical steroids. Th-2 type cytokine production (interleukin-4 [IL-4] and interleukin-5 [IL-5]) has been demonstrated to play a significant role in the pathophysiology of allergic rhinitis (AR), and the treatment of AR with topical corticosteroids has been shown to reduce the expression of Th-2 type cytokines in vivo. However, the contribution and expression of Th-2 type cytokine receptors in AR and their response (...) to corticosteroid treatment remain to be clarified. Objectives of the current study are 1. To examine the expression of the cytokine IL-4 and IL-5 receptors (IL-4R and IL-5R) in a nasal allergen challenge model and to contrast this with the expression of the receptor for the Th-1 type cytokine, interferon-gamma receptor (IFN-gammaR), and 2. to examine the effects of pretreatment with topical corticosteroid before allergen challenge on the expression of these same receptors.Randomized prospective study involving

1998 Laryngoscope Controlled trial quality: uncertain

28067. Effect of topical anti-inflammatory treatment on the long-term outcome of laser trabeculoplasty. Fluorometholone-Laser Trabeculoplasty Study Group. (Abstract)

postoperative period, peri-argon laser trabeculoplasty use of a topical corticosteroid did not influence the long-term intraocular pressure outcome of argon laser trabeculoplasty. (...) Effect of topical anti-inflammatory treatment on the long-term outcome of laser trabeculoplasty. Fluorometholone-Laser Trabeculoplasty Study Group. To investigate the effect of anti-inflammatory treatment on the long-term outcome of argon laser trabeculoplasty, we extended the short-term study of the Fluorometholone-Laser Trabeculoplasty Study Group.Among the chronic open-angle glaucoma patients randomly assigned to the 0.25% fluorometholone or placebo eyedrops four times daily before and after

1998 American journal of ophthalmology Controlled trial quality: uncertain

28068. Elidel (pimecrolimus) cream 1%: a nonsteroidal topical agent for the treatment of atopic dermatitis. (Abstract)

Elidel (pimecrolimus) cream 1%: a nonsteroidal topical agent for the treatment of atopic dermatitis. Elidel is a steroid-free cream containing a 1% strength of the topical immunomodulator pimecrolimus. Elidel was specifically developed as a treatment for atopic dermatitis (AD) and is approved for use in children as young as 2 years of age. The production of inflammatory cytokines by activated T cells in skin is thought to play an important role in the pathogenesis of AD. Elidel potently (...) and is maintained for the duration of treatment. Elidel is well tolerated; the risk of application-site reactions, such as itching or burning, is comparable with that of the vehicle. Adverse effects were generally mild in patients receiving Elidel and occurred at rates comparable with those in patients receiving vehicle treatment. In a 1-year study, Elidel significantly reduced the incidence of flares when used at the first signs and symptoms of acute AD. As a result, overall corticosteroid use to treat flares

2003 The Journal of allergy and clinical immunology

28069. Topical calcipotriene for morphea/linear scleroderma. (Abstract)

of localized scleroderma.In a 3-month open-label study, 12 patients aged 12 to 38 years with biopsy-documented active morphea or linear scleroderma applied calcipotriene ointment under occlusion twice daily to plaques for 3 months. The condition of each patient had previously failed to respond to potent topical corticosteroids and, for some patients, systemic medications. Efficacy was assessed at baseline, 1 month, and 3 months. Levels of serum ionized calcium, intact parathyroid hormone, and 1,25 (...) Topical calcipotriene for morphea/linear scleroderma. Morphea and linear scleroderma are characterized by erythema, induration, telangiectasia, and dyspigmentation. There is no universally effective treatment. Oral calcitriol has been beneficial in the treatment of localized and extensive morphea/scleroderma, but the use of topical calcipotriene has not been reported.The purpose of this study was to evaluate the efficacy and safety of topical calcipotriene 0.005% ointment in the treatment

1998 Journal of the American Academy of Dermatology

28070. Topical steroid, cyclosporin A, and the outcome of rat corneal allografts. Full Text available with Trip Pro

Topical steroid, cyclosporin A, and the outcome of rat corneal allografts. The effects of a combination of topical corticosteroid and cyclosporin A on corneal graft survival were tested in a model of penetrating keratoplasty in the inbred rat. Topical medications were applied four times daily to the graft for 28 days postgraft. Neither topical steroid (1% prednisolone acetate) nor topical cyclosporin (1% in chremophor EL/ethanol) was able to modify the overall incidence of rejection, though all

1987 The British journal of ophthalmology

28071. Side to side comparison of topical treatment in atopic dermatitis Full Text available with Trip Pro

Side to side comparison of topical treatment in atopic dermatitis To document and evaluate the outcome of side to side comparisons of different corticosteroids in determining the most effective topical treatment for individuals admitted to hospital for control of atopic dermatitis.Retrospective case note study of 82 admissions (66 children) to a children's hospital for treatment of atopic dermatitis between 1 June 1993 and 31 October 1995. Different topical corticosteroid ointments were applied (...) to the two sides of the body. The outcome measure was a comparison between the two sides, to see whether one treatment was better than the other.More potent topical corticosteroid preparations appeared more effective than weaker preparations on 25 occasions, there was no difference on 20 occasions, and on seven occasions a weaker preparation appeared more effective. Incorporation of an antimicrobial agent did not appear to increase the efficacy of a preparation.The management of atopic dermatitis

1998 Archives of Disease in Childhood

28072. Topical diclofenac in the treatment of ocular pain after excimer photorefractive keratectomy. (Abstract)

Topical diclofenac in the treatment of ocular pain after excimer photorefractive keratectomy. Following excimer laser photorefractive keratectomy, patients experience significant ocular pain until corneal reepithelialization. Despite the use of cold compresses, bandage soft contact lenses, cycloplegics, narcotics, and topical corticosteroids, the pain has not been adequately controlled in many patients.A randomized, double-masked, parallel-group study of diclofenac sodium 0.1% ophthalmic (...) solution and its placebo vehicle was evaluated. Patients undergoing excimer myopic photorefractive keratectomy on their second eye were admitted overnight. Postoperative procedures included two drops of diclofenac or placebo immediately after surgery and then qid until reepithelialization, topical tobramycin (qid), 0.1% fluorometholone (q2h), cycloplegics, and a disposable soft contact lens. Thirty-two patients (diclofenac = 16, placebo = 16) were evaluated from +30 minutes to +96 hours by several

1994 Refractive & corneal surgery Controlled trial quality: uncertain

28073. [Anti-inflammatory effect of topical diclofenac sodium (Voltarène Ophta) after argon laser trabeculoplasty: preliminary results of a prospective double-blind method]. (Abstract)

angle glaucomas (POAG). We also showed that topical diclofenac reduced inflammation in all 17 treated patients. Prostaglandins are thought to play a major role in ALT-inflammation and it is therefore logical to assume that NSAID are effective in that situation and will probably advantageously replace corticosteroids. In order to assess the anti-inflammatory effect of diclofenac drops (Voltaren Ophtha) we included a total of 37 PIG or PEXG (19 in the diclofenac and 18 in the placebo group) scheduled (...) [Anti-inflammatory effect of topical diclofenac sodium (Voltarène Ophta) after argon laser trabeculoplasty: preliminary results of a prospective double-blind method]. Using the laser flare-cell meter (LFMC), we have previously determined the intensity and pattern of post-ALT ocular inflammation. Inflammation peak occurs 48 hours after ALT and clinically relevant inflammation is seen in 100% of pigmentary glaucomas (PIG), 75% of pseudoexfoliative glaucomas (PEXG) but only in 25% of primary open

1992 Klinische Monatsblatter fur Augenheilkunde Controlled trial quality: uncertain

28074. Influence of topical steroid treatment on maxillary sinusitis. (Abstract)

Influence of topical steroid treatment on maxillary sinusitis. The clinical efficacy and adverse effects of budesonide administered as a nasal aerosol in addition to sinus washings and erythromycin therapy was assessed by comparison with placebo in a randomized, double-blind study of 40 patients with chronic or recurrent maxillary sinusitis. Most of the patients had been referred for operative treatment. Corticosteroid therapy, 400 micrograms daily, or placebo was continued for 3 months (...) epidermidis and Haemophilus influenzae. Only 2 of 20 Haemophilus strains were beta-lactamase producers. The cellular picture was dominated by neutrophils in all secretions. There was no significant difference in clinical outcome between the two groups. Topical steroid therapy did not cause any adverse effects.

1992 Rhinology Controlled trial quality: uncertain

28075. Long-term management of atopic dermatitis in infants with topical pimecrolimus, a nonsteroid anti-inflammatory drug. (Abstract)

Long-term management of atopic dermatitis in infants with topical pimecrolimus, a nonsteroid anti-inflammatory drug. Pimecrolimus cream 1% (Elidel, SDZ ASM 981), a nonsteroid selective inhibitor of inflammatory cytokines, is effective in the treatment of atopic dermatitis (AD). In this study we compared early intervention with pimecrolimus cream with treatment with a vehicle control.The purpose of this investigation was to assess whether early treatment in infants of AD signs/symptoms (...) of flares, moderately potent corticosteroid was permitted in both groups. The primary efficacy end point was the incidence of flares at 6 months.Pimecrolimus significantly reduced the incidence of flares compared with control treatment (P <.001), with 67.6% versus 30.4% of patients completing 6 months with no flare and 56.9% versus 28.3% completing 12 months with no flare. Overall corticosteroid use was substantially lower in the pimecrolimus group: 63.7% versus 34.8% of patients did not use

2002 The Journal of allergy and clinical immunology Controlled trial quality: uncertain

28076. Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis. (Abstract)

Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, Rhino-conjunctivitis Quality of Life Questionnaire, and a daily diary recording nasal symptoms, sleep problems, and daytime fatigue.The results illustrated that the topical nasal corticosteroid significantly improved daytime fatigue (P = 0.03), somnolence (P = 0.02), and quality of sleep (P = 0.05) compared to placebo in patients suffering from PAR.Budesonide is able to improve congestion, sleep, and daytime somnolence. (...) Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis. Improving quality of life is considered to be a major endpoint and motivation for clinical intervention in patients with perennial allergic rhinitis (PAR). In addition to classical symptoms of congestion, pruritus, and rhinorrhea, patients will often complain of not being able to sleep well at night and of feeling fatigued during the day. Like sleep apnea, PAR

2003 Allergy Controlled trial quality: uncertain

28077. Comparison of topical prednisolone acetate, ketorolac tromethamine and fluorometholone acetate in reducing inflammation after phacoemulsification. (Abstract)

Comparison of topical prednisolone acetate, ketorolac tromethamine and fluorometholone acetate in reducing inflammation after phacoemulsification. To compare the efficacy and ocular adverse effects of topical prednisolone acetate, ketorolac tromethamine, and fluorometholone acetate in reducing inflammation after phacoemulsification.One hundred and twenty eyes were enrolled in a prospective, investigator-masked, randomized controlled trial. Each drug was prescribed 4 times a day for 28 days (...) on day 21 (14.6:12.2 mmHg, p = 0.016). One eye in the prednisolone group had intraocular pressure of 32 mmHg. Burning sensation was reported frequently in the ketorolac group.All 3 drugs were effective in reducing post-operative inflammation. The efficacy of prednisolone acetate and fluorometholone acetate was comparable. Ketorolac tromethamine showed less efficacy than corticosteroids, however, it did not induce ocular hypertension.

2003 Journal of the Medical Association of Thailand = Chotmaihet thangphaet Controlled trial quality: uncertain

28078. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. (Abstract)

Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. The involvement of Candida in the pathogenesis of chronic paronychia (CP) has never been proven, even though this condition is commonly considered a type of Candida onychomycosis.The purpose of this study was to compare the efficacy of systemic antifungals (itraconazole or terbinafine) with a topical corticosteroid (methylprednisolone aceponate (...) a significant difference between the number of nails improved or cured by methylprednisolone aceponate and that of nails improved or cured with terbinafine (30 out of 57) or itraconazole (29 out of 64). Presence of Candida was not strictly linked to disease activity, and Candida eradication was associated with clinical cure in only 2 of the 18 patients who carried Candida at the beginning of the study.This study shows that topical steroids are more effective than systemic antifungals in the treatment of CP

2002 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

28079. [Topical treatment of atopic dermatitis with Hypericum cream. A randomised, placebo-controlled, double-blind half-side comparison study]. (Abstract)

the Hypericum cream and the vehicle (secondary endpoints).Hypericum cream was significantly superior to its vehicle in the topical treatment of mild to moderate atopic dermatitis. The therapeutic efficacy of the Hypericum cream should be evaluated in further studies with larger patient cohorts, in comparison to standard therapeutic agents (i.e. corticosteroids). (...) [Topical treatment of atopic dermatitis with Hypericum cream. A randomised, placebo-controlled, double-blind half-side comparison study]. Recent investigations suggest an anti-inflammatory and antibacterial effect of hyperforin, which is a major constituent of Hypericum perforatum L. (Saint John's wort).In a half-side comparison study we assessed the efficacy of a cream containing Hypericum extract standardized to 1.5% hyperforin (verum) in comparison to the corresponding vehicle (placebo

2003 Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete Controlled trial quality: uncertain

28080. Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery. (Abstract)

Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery. Whether instillation into the maxillary sinus of topical budesonide affected the immune response and improved allergic patients with chronic rhinosinusitis that had persistence of symptoms despite appropriate surgical intervention was assessed.Double-blind placebo-controlled.Twenty-six patients with allergy to house dust mites who had previously had surgery and who had persistent (...) symptoms of disabling rhinorrhea or pressure-pain resistant to oral antibiotics and intranasal corticosteroids were recruited. During the double-blind study, patients instilled 256 microg budesonide daily or placebo through an intubation device (maxillary antrum sinusotomy tube) into one of the maxillary sinuses for 3 weeks before clinical assessment and a second biopsy.We found an improvement in the symptom scores in 11 of the 13 patients who received budesonide; we also found a decrease in CD-3 (P

2002 Laryngoscope Controlled trial quality: uncertain

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