Indications

Clascon cream is an androgen receptor inhibitor indicated for the topical treatment of acne vulgaris in patients 12 years of age and older.

Pharmacology

Clascoterone (cortexolone 17 a-propionate) is a novel antagonist of androgen receptors. It binds to androgen receptors with high affinity. By competing with androgens for binding to androgen
receptors, Clascoterone works by blocking the androgen receptor signaling cascades that promotes acne pathogenesis such as sebaceous gland proliferation, excess sebum production and
inflammatory pathways.

Acne is a multifactorial skin condition characterized by excess sebum production, epithelial hyperkeratinization, proliferation of the skin commensal bacteria, and inflammation. Circulating and locally
synthesized natural ligands, testosterone and dihydrotestosterone (DHT), serve as causative factors in both males and females. Upon binding of DHT, the DHT-androgen receptor complex dimerizes
and translocates to the nucleus where it promotes the transcription of genes involved in acne pathogenesis, including proliferation and differentiation of sebocytes, excess sebum production, and
inflammatory cytokine production. Clascoterone is a potent antagonist at ARs and competes for androgens in binding to the receptor, thereby inhibiting downstream signalling of ARs that promote
acne

Androgenetic alopecia is also an androgen-dependent and highly genetic condition. Dihydrotestosterone (DHT) binds to ARs expressed on dermal papilla cells (DPC) in the scalp to induce AR-mediated
transcription of genes that contribute to androgenic alopecia. By blocking the interaction between DHT and aARs, clascoterone inhibits AR-regulated transcription and DHT-induced IL-6 synthesis.

Dosage & Administration

Clean the affected area gently then apply a thin uniform layer (approximately 1 gm) of Clascoterone
cream twice per day in the morning and evening to the affected area. Avoid accidental transfer of Clascoterone cream into eyes, mouth, or other mucous membranes. If contact with mucous
membranes occurs, this should be rinsed thoroughly with water or as directed by physician.

Use in Children and Adolescents: Safety and effectiveness of Clascoterone cream for the topical treatment of acne vulgaris have not been established in pediatric patients under 12 years of age

Interaction

No clinical study evaluating the drug interaction of Clascon cream has been conducted.

Contraindications

Data of contraindication of clascoterone cream in not available.

Side Effects

Most common adverse reactions occurring in 7% to 12% of patients are erythema/ reddening, pruritus, and scaling/dryness. Additionally, >3% of patients may suffer from edema, stinging and burning.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another
drug and may not reflect the rates observed in practice.

In two identical multicenter, randomized, double-blind, vehicle-controlled trials, 1421 subjects 12 years and older with facial acne vulgaris applied Clascon cream or vehicle twice daily for 12 weeks.
Overall, 62% of the subjects were female, and 38% were male, 91% of the patients were Caucasian, and the mean age was 19.7 years.

Local skin reactions (edema, erythema/redness, pruritus, scaling/dryness, skin atrophy, stinging/buming, striae rubrea, telangiectasia) were observed during the 12-week treatment and occurred in a
similar percentage of subjects treated with vehicle.

Pregnancy & Lactation

There is no available data on clascoterone cream use in pregnant women to evaluate a drug associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. There is no data
regarding the presence of Clascoterone or metabolite in human milk or the effects on milk production and breastfed infant.