Cortisone
| Evidence Level: L5 | Predicted Indications: 7 |
Table of Contents
Cortisone: Primary cutaneous T-cell lymphoma
One-Sentence Summary
Cortisone is an oral corticosteroid (glucocorticoid) marketed in Australia. The TxGNN model predicts it may be relevant to primary cutaneous T-cell lymphoma, but the supporting evidence is thin: 1 clinical trial that does not study this disease or cortisone, and 5 publications, all historical case reports or reviews from 1951 to 1964.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Primary cutaneous T-cell lymphoma |
| TxGNN Prediction Score | 0.9967 |
| Evidence Level | L5 |
| Australia Market Status | Listed on the PBS Schedule (1 of 1 items) – TGA (ARTG) registration status is not included in this data |
| Number of PBS Items | 1 (valid: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. As a class, corticosteroids have lympholytic activity: they act through the glucocorticoid receptor and can trigger apoptosis in lymphoid cells. This offers a plausible biological link to T-cell lymphoma.
The link is general rather than specific to cortisone. The literature on this disease consists of mid-20th-century case reports on mycosis fungoides, the most common form of cutaneous T-cell lymphoma. No modern study tests cortisone in this condition. The mechanistic argument therefore rests on the glucocorticoid class, not on evidence for cortisone itself.
Clinical Trial Evidence
| Trial Number | Phase | Status | Enrolment | Key Findings |
|---|---|---|---|---|
| NCT04799275 | Phase 2/3 | Active, not recruiting | 422 | R-miniCHOP with or without oral azacitidine in patients aged 75 or older with diffuse large B-cell lymphoma. This is a B-cell disease, and cortisone is not studied (prednisone is only a regimen component). Not directly relevant. |
No trial directly studies primary cutaneous T-cell lymphoma.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 14169182 | 1964 | Review | Journal de medecine et de chirurgie pratiques | General review of mycosis fungoides (no abstract available). |
| 14884116 | 1951 | Case report | Svenska lakartidningen | Combined ACTH and cortisone therapy in a patient with impetigo herpetiformis, mycosis fungoides and erythroderma psoriatica. |
| 14896727 | 1951 | Case report | Dermatologica | Effects of cortisone in two cases of mycosis fungoides. |
| 13612293 | 1958 | Case report | Lyon medical | Two cases of mycosis treated with delta-cortisone; a terminal ulceronecrotic process was probably linked to the medication. |
| 13536705 | 1957 | Case report | Bulletin de la Societe francaise de dermatologie et de syphiligraphie | Two cases of bronchial epithelioma in patients with mycosis fungoides treated with cortisone. |
Australia Market Information
| ARTG Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 1246N | Cortate | Tablet containing cortisone acetate 5 mg (oral) | Not stated in the data compiled |
Safety Considerations
Please refer to the TGA-approved Product Information (PI) for safety information. No drug interaction records were found in the data compiled for this report.
Conclusion and Next Steps
Decision: Hold
Rationale: No cited study directly tests cortisone in primary cutaneous T-cell lymphoma in a controlled or modern setting. The only evidence is 1950s–1960s case reports, and the single linked trial concerns a different (B-cell) lymphoma. The prediction is therefore at the model-prediction level (L5), with a plausible but class-level glucocorticoid mechanism.
To proceed, the following is needed:
- Mechanism of action data for cortisone specifically
- Contemporary clinical evidence for cortisone, or for systemic corticosteroids more broadly, in cutaneous T-cell lymphoma
- Safety information from the TGA-approved Product Information, including warnings and contraindications
- Comparison against current standard therapies for cutaneous T-cell lymphoma to define any added role
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.