Topical calcipotriol combined with phototherapy for psoriasis. The results of two randomized trials and a review of the literature. Calcipotriol-UVB Study Group.

Abstract

BACKGROUND:

Calcipotrial has a well-documented effect in the treatment of psoriasis.

OBJECTIVE:

To confirm the beneficial effect of the combination of calcipotriol and UVB and to demonstrate that the combination is safe and well tolerated.

METHODS:

Data from two randomized right/left studies were analysed. Patients included in the studies had chronic stable plaque-type psoriasis with symmetrical lesions on the arms, the legs and/or the trunk. In one study, 101 patients were treated with calcipotriol on one side and calcipotriol + UVB on the other side of the body (open study). In the other study, 77 patients were treated with calcipotriol + UVB on one side and vehicle + UVB on the other side of the body (double-blind study). Calcipotriol ointment, 50 microg/g, was applied twice daily and UVB 3 times weekly for 8 weeks. UVB was increased from 0.7 MED before treatment in rapid steps up to the erythema threshold.

RESULT:

In both treatment series the therapeutic effect of the combination of calcipotriol and UVB was enhanced as compared to calcipotriol alone and UVB alone. In the first series there was a significant reduction of the psoriasis area and severity index (PASI) with the combination after 2 weeks as compared to calcipotriol alone. At the end of treatment significantly more sides were cleared after calcipotriol + UVB than after calcipotriol alone. In the other series there was a significantly faster onset of improvement on the sides treated with calcipotriol + UVB than on those treated with vehicle + UVB. After 2 weeks there was a significant difference in PASI in favour of calcipotriol + UVB. At the end of treatment, however, there was no difference between the treatments. There was a similar adverse event profile with either treatment. The addition of UVB to calcipotriol did not alter the tolerability or safety of topically applied calcipotriol.

CONCLUSIONS:

The result indicates a beneficial effect of combining calcipotriol and phototherapy. The findings are compared to other published studies.

• Authors: L Molin
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 198 Issue 4 Pg. 375-81 ( 1999) ISSN: 1018-8665 [Print] Switzerland
• PMID: 10490297 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Dermatologic Agents
• calcipotriene
• Calcitriol

Topics

• Administration, Cutaneous
• Calcitriol (adverse effects, analogs & derivatives, therapeutic use)
• Combined Modality Therapy
• Dermatologic Agents (adverse effects, therapeutic use)
• Female
• Folliculitis (etiology)
• Follow-Up Studies
• Humans
• Male
• Phototherapy (adverse effects)
• Psoriasis (pathology, therapy)
• Severity of Illness Index
• Skin (drug effects, pathology, radiation effects)
• Sunburn (etiology)
• Treatment Outcome
• Ultraviolet Rays