Does topical clobetasol (corticosteroid) for treatment of lichen sclerosis affect Ocrevus (ocrelizumab) infusions?

From the Guidelines

There is no known significant interaction between topical clobetasol used for lichen sclerosis and Ocrevus infusions, and you can generally continue using topical clobetasol while receiving Ocrevus treatment. Topical corticosteroids like clobetasol are applied directly to the skin and have minimal systemic absorption when used as directed, which means they typically don't enter the bloodstream in significant amounts that would interfere with Ocrevus 1. Ocrevus works by targeting B cells in your immune system to treat multiple sclerosis, while topical clobetasol works locally to reduce inflammation and symptoms of lichen sclerosus.

Some key points to consider:

• The British Association of Dermatologists' guidelines for the management of lichen sclerosus recommend the use of topical clobetasol propionate 0.05% as the first-line treatment for adult female anogenital lichen sclerosus 1.
• There is no evidence to suggest that topical clobetasol affects the efficacy or increases the risk of adverse effects of Ocrevus infusions.
• However, it's always important to inform your neurologist and dermatologist about all medications you're using, including topical treatments.
• If you're using high-potency clobetasol over large areas of skin or for extended periods, there could potentially be more systemic absorption, which might theoretically have some immunosuppressive effects that could compound with Ocrevus's immunosuppressive properties 1.

In terms of treatment regimen, the recommended regimen for topical clobetasol is to apply it once daily, at night, for 4 weeks, then on alternate nights for 4 weeks, and then twice weekly for a further 4 weeks, before review 1. It's essential to follow your prescribed regimen for both medications and report any unusual symptoms to your healthcare providers.

From the Research

Topical Clobetasol and Lichen Sclerosis

• Topical clobetasol is a superpotent topical corticosteroid used to treat lichen sclerosis, a chronic cutaneous disorder 2.
• The use of topical clobetasol for lichen sclerosis has been shown to be effective, but it can cause dermal atrophy as a side effect 2.

Ocrevus Infusions

• There is no direct evidence in the provided studies that topical clobetasol for the treatment of lichen sclerosis affects Ocrevus (ocrelizumab) infusions.
• Ocrevus is a medication used to treat multiple sclerosis and is not mentioned in the provided studies on lichen sclerosis [no relevant references].

Alternative Treatments for Lichen Sclerosis

• Alternative treatments for lichen sclerosis, such as pimecrolimus and tacrolimus, have been shown to be safe and effective 3, 4, 5, 6.
• These alternative treatments may be considered for patients who do not respond to topical corticosteroids or who experience side effects 2, 3, 4, 5, 6.