Comment: The quality of evidence is downgraded by study limitations (unclear sequence generation, allocation concealment, and blinding) and by imprecise results (few patients).
A Cochrane review included 7 studies with a total of 249 subjects. Clobetasol propionate 0.05% was better than placebo for 'participant-rated improvement or remission of symptoms' (RR 2.85, 95% CI 1.45 to 5.61; 1 trial, n=39) and 'investigator-rated global degree of improvement' (standardised mean difference (SMD) 5.74, 95% CI 4.26 to 7.23; 1 trial, n=39). When mometasone furoate 0.05% was compared to placebo, there was a significant improvement in the 'investigator-rated change in clinical grade of phimosis' (SMD -1.04, 95% CI -1.77 to -0.31; 1 trial, n=33). Both trials found no significant differences in reported adverse drug reactions between the corticosteroid and placebo groups. The data from four trials found no significant benefit for topical testosterone, dihydrotestosterone, and progesterone. One trial (n=36) found no differences between pimecrolimus and clobetasol propionate in relieving symptoms through change in pruritus and burning/pain. However, pimecrolimus was less effective than clobetasol propionate with regard to the 'investigator-rated global degree of improvement' (SMD -1.64, 95% CI -2.40 to -0.87).
Date of latest search: 2012-02-22