A double-blind, randomized clinical study was conducted to compare the efficacy and tolerability of twice-daily topical
calcipotriol treatment with a combination treatment of
calcipotriol once a day in the morning and
diflucortolone valerate in the evening. Sixty-three patients with a clinical diagnosis of chronic plaque
psoriasis and comparable psoriatic lesions on both sides of the body were included. After a washout phase of 1 week, psoriatic lesions were treated for 4 weeks with
calcipotriol ointment twice daily on one side of the body and a combination of
calcipotriol and
diflucortolone valerate ointment on the other side. The treatment period was followed by a period of 4 weeks without any treatment. The
psoriasis area and severity index (PASI) was used to compare the 2 groups. Furthermore, the overall therapeutic results were assessed independently by the investigators and by the patients. Both treatment regimens showed a significant, nearly identical, reduction in PASI. The mean PASI for
calcipotriol alone was 5.7 at baseline, 1.9 after 4 weeks of treatment and 3.8 at the end of the follow-up period. For combination
therapy, these values were 5.7, 1.8 and 3.8, respectively. There was a statistically significant advantage in favor of combined
calcipotriol and
diflucortolone valerate treatment at weeks 1 and 2 (p < 0.05); however, at the end of the treatment phase the difference between the 2
therapies was not significant. Subjective evaluation of efficacy by both the investigators and the patients revealed no difference between the 2 treatments. The frequency of side effects (e.g. irritation) was low in both groups. In conclusion, both
therapies were effective for the treatment of chronic plaque-type psoriatic lesions. The combination of
calcipotriol and a topical
steroid appeared to produce a more rapid clinical response and was shown to be as effective as
calcipotriol therapy alone.