Hydrocortisone Acetate
| Evidence Level: L2 | Predicted Indications: 9 |
Table of Contents
Hydrocortisone Acetate: Alopecia areata
One-Sentence Summary
Hydrocortisone acetate is a corticosteroid with anti-inflammatory and immunosuppressive activity. The TxGNN model predicts it may be useful for alopecia areata, with 1 clinical trial (where hydrocortisone served as a comparator) and 2 publications (one historical case series) currently related to this direction. The evidence level is L2.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Alopecia areata |
| TxGNN Prediction Score | 0.9994 |
| Evidence Level | L2 |
| Canada Market Status | Marketed (marketed DINs: 8 of 8) |
| Number of DINs | 8 (marketed: 8) |
| Recommended Decision | Proceed with Guardrails |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on general corticosteroid pharmacology, hydrocortisone suppresses inflammatory and immune responses.
Alopecia areata is an autoimmune, T-cell-mediated attack on hair follicles, so an immunosuppressive corticosteroid is mechanistically plausible. Hydrocortisone is a low-potency steroid, so its effect is expected to be weaker than that of high-potency agents such as clobetasol. This link rests on general pharmacology rather than drug-specific mechanism data.
Clinical Trial Evidence
| Trial Number | Phase | Status | Enrollment | Key Findings |
|---|---|---|---|---|
| NCT01453686 | Phase 3 | Completed | 41 | Randomized trial in children with alopecia areata comparing clobetasol propionate 0.05% cream with hydrocortisone 1% cream. Hydrocortisone was the low-potency comparator, so the trial does not directly demonstrate its efficacy. |
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 4755919 | 1973 | Case series | Przeglad dermatologiczny | Intralesional subcutaneous injections of hydrocortisone acetate suspension for severe forms of alopecia areata. No abstract available. |
| 153470 | 1979 | Review | MMW, Munchener medizinische Wochenschrift | General review of topical skin disease therapy; compares the anti-inflammatory effect of a newer steroid with hydrocortisone acetate. Not specific to alopecia areata. |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 02236399 | ANODAN-HC 10MG SUPPOSITORIES | Not stated | Not stated |
| 02387239 | JAMPZINC-HC | Not stated | Not stated |
| 02128446 | ANODAN-HC OINTMENT | Not stated | Not stated |
| 02238578 | FUCIDIN H | Not stated | Not stated |
| 00505773 | ANUSOL-HC OINTMENT | Not stated | Not stated |
Eight licences are valid in Canada; the five above are shown.
Safety Considerations
Contraindication signals recorded for this drug include hypertension, epilepsy, gastric ulcer, kidney disease, liver disease, hyperglycemia, measles, herpes simplex virus keratitis, and pituitary hormone deficiency conditions. These are not drawn from label text, so please refer to the package insert for authoritative safety information.
Conclusion and Next Steps
Decision: Proceed with Guardrails
Rationale: A completed randomized trial in alopecia areata included hydrocortisone 1% cream as a comparator, and an older case series reported intralesional hydrocortisone acetate. This supports plausibility (L2), but hydrocortisone was not the investigational agent and evidence is limited and dated.
To proceed, the following is needed:
- Trial results for NCT01453686 showing hydrocortisone’s own response rate
- Modern controlled studies of hydrocortisone in alopecia areata
- Detailed mechanism of action data
- Package insert warnings and contraindications review
- Assessment of route and formulation suitability (current Canadian products are rectal and topical anorectal preparations)
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.