Cortisone Acetate
| Evidence Level: L4 | Predicted Indications: 8 |
Table of Contents
Cortisone Acetate: Glucocorticoid prodrug → alopecia areata
One-Sentence Summary
Cortisone acetate is a glucocorticoid prodrug that is converted in the body to cortisol, giving anti-inflammatory and immunosuppressive effects. The TxGNN model predicts it may be effective for alopecia areata, but the supporting evidence is limited to 0 clinical trials and 2 publications (both case-level reports from 1952).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | alopecia areata |
| TxGNN Prediction Score | 0.9995 |
| Evidence Level | L4 |
| Canada Market Status | Marketed (marketed DINs: 1 of 1) |
| Number of DINs | 1 (marketed: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Based on known pharmacology, cortisone acetate is a prodrug converted to cortisol by 11-beta-HSD1, which produces glucocorticoid anti-inflammatory and immunosuppressive effects.
Alopecia areata is an autoimmune disease in which T cells attack the hair follicle. Corticosteroids are an established therapy class for it (intralesional, topical, and short-course systemic), so an immunosuppressive glucocorticoid is mechanistically plausible. However, oral cortisone acetate itself is no longer used for this condition. Systemic steroids tend to be followed by relapse after withdrawal and carry significant adverse effects.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 14908175 | 1952 | Case report/series | The Journal of Investigative Dermatology | Treatment of alopecia areata totalis and universalis with cortisone acetate (no abstract available) |
| 14952032 | 1952 | Case report | A.M.A. Archives of Dermatology and Syphilology | One case of alopecia areata universalis treated with ACTH and intramuscular cortisone acetate, with post-treatment observations (no abstract available) |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 00280437 | CORTISONE ACETATE | Not recorded | Not recorded |
Safety Considerations
- Contraindications recorded for related conditions (not label text): hypertension, epilepsy, gastric ulcer, kidney disease, liver disease, gallbladder disease, hyperglycemia, measles, herpes simplex keratitis, human papillomavirus infections (including common wart), and pituitary hormone deficiency conditions such as hypopituitarism and Kallmann syndrome.
Please refer to the package insert for full warnings and drug interaction information.
Conclusion and Next Steps
Decision: Hold
Rationale: The only direct evidence is two case-level reports from 1952 without abstracts, and no clinical trials exist. Corticosteroids are plausible for alopecia areata, but systemic cortisone acetate has a high relapse rate and a significant adverse-effect burden, so the evidence does not support moving forward now.
To proceed, the following is needed:
- Health Canada package insert warnings and contraindications (a blocking gap for safety screening)
- Detailed mechanism of action data
- Comparison against current corticosteroid and other alopecia areata treatments
- Controlled clinical data on efficacy, relapse after withdrawal, and safety
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.