The comparative effectiveness of clascoterone between males and females was not described.A small pilot randomized controlled trial in 2011 found that clascoterone cream decreased acne symptoms to a similar or significantly greater extent than tretinoin 0.05% cream. No active comparator was used in the phase III clinical trials of clascoterone for acne. Hence, its unclear how clascoterone compares to other therapies used in the treatment of acne. Available forms
Clascoterone is available in the form of a 1% (10 mg/g) cream for topical use. Contraindications
Clascoterone has no contraindications. Side effects
The incidences of local skin reactions with clascoterone were similar to placebo in two large phase 3 randomized controlled trials. Suppression of the hypothalamic–pituitary–adrenal axis (HPA axis) may occur during clascoterone therapy in some individuals due to its cortexolone metabolite. HPA axis suppression as measured by the cosyntropin stimulation test was observed to occur in 3 of 42 (7%) of adolescents and adults using clascoterone for acne. HPA axis function returned to normal within 4 weeks following discontinuation of clascoterone. Hyperkalemia (elevated potassium levels) occurred in 5% of clascoterone-treated individuals and 4% of placebo-treated individuals. Pharmacology
Pharmacodynamics
Clascoterone is a steroidal antiandrogen, or antagonist of the androgen receptor (AR), the biological target of androgens such as testosterone and dihydrotestosterone (DHT). In a bioassay, the topical potency of the medication was greater than that of progesterone, flutamide, and finasteride and was equivalent to that of cyproterone acetate.
Drug-induced autoimmune hemolytic anemia is a form of hemolytic anemia. In some cases, a drug can cause the immune system to mistakenly think the bodys own red blood cells are dangerous, foreign substances. Antibodies then develop against the red blood cells. The antibodies attach to red blood cells and cause them to break down too early. It is known that more than 150 drugs can cause this type of hemolytic anemia. The list includes :

Cephalosporins (a class of antibiotics)
Dapsone
Levodopa
Levofloxacin
Methyldopa
Nitrofurantoin
Nonsteroidal anti-inflammatory drugs (NSAIDs) - among them, the commonly used Diclofenac and Ibuprofen
Phenazopyridine (pyridium)
QuinidinePenicillin in high doses can induce immune mediated hemolysis via the hapten mechanism in which antibodies are targeted against the combination of penicillin in association with red blood cells. Complement is activated by the attached antibody leading to the removal of red blood cells by the spleen.The drug itself can be targeted by the immune system, e.g. by IgE in a Type I hypersensitivity reaction to penicillin, rarely leading to anaphylaxis. See also
List of circulatory system conditions
List of hematologic conditions

References


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