An investigator-initiated, double-blind, vehicle-controlled pilot study: assessment for tachyphylaxis to topically occluded halobetasol 0.05% ointment in the treatment of psoriasis.

Abstract

BACKGROUND:

Topical corticosteroids are the most common first-line treatment for psoriasis. Tachyphylaxis, a decreased response to treatment with repetitive application of the drug, is a controversial phenomenon associated with topical corticosteroid treatment.

OBJECTIVE:

We sought to prove or disprove tachyphylaxis to occluded halobetasol 0.05% versus vehicle.

METHODS:

Patients with plaque psoriasis were recruited to this study. The study involved 3 phases (1, 2A, and 2B) with each phase being separated by a treatment vacation period. In phases 1 and 2A, 2 plaques were randomized to either halobetasol 0.05% or vehicle ointment application. In phase 2B, halobetasol 0.05% was applied to both. Target Lesion Severity Scale was used for clinical assessment.

RESULTS:

Twenty patients were enrolled. No difference in time to clearance (P=.88) or time to recurrence (P=.92) of the treated plaques was found between phases 1 and 2A. Percentage of improvement was higher in phase 2A compared with phase 1 (89.4%, P<.05 vs 71%, P<.05), as a result of reduction of vehicle effect. In phase 2B, a greater improvement was found for previously corticosteroid-treated plaques.

LIMITATIONS:

Limitations are small sample size and 1 corticosteroid tested.

CONCLUSION:

No evidence of tachyphylaxis to the topical corticosteroid halobetasol 0.05% ointment treatment in patients with plaque psoriasis was found.

• Authors: Tali Czarnowicki, Rita V Linkner, Mayte Suárez-Fariñas, Arie Ingber, Mark Lebwohl
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 71 Issue 5 Pg. 954-959.e1 (Nov 2014) ISSN: 1097-6787 [Electronic] United States
• PMID: 24929883 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Dermatologic Agents
• Ointments
• halobetasol
• Clobetasol

Topics

• Administration, Cutaneous
• Adult
• Clobetasol (administration & dosage, analogs & derivatives)
• Dermatologic Agents (administration & dosage)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Ointments (administration & dosage)
• Pilot Projects
• Psoriasis (drug therapy)
• Severity of Illness Index
• Tachyphylaxis
• Young Adult