Real-World Experience Using Topical Therapy—Calcipotriol and Betamethasone Dipropionate Foam in Adults with Beyond-Mild Psoriasis

Abstract

Introduction: Determining optimal treatment for moderate plaque psoriasis can be challenging. Recent studies have demonstrated the effectiveness of calcipotriol and betamethasone dipropionate (Cal/BD) foam in patients with moderate-to-severe plaque psoriasis. Methods: This research explored the use of Cal/BD foam in patients with beyond-mild psoriasis (defined as patients eligible for topical treatment, systemic treatment, or combined topical/systemic treatments) using an online questionnaire, retrospective medical-record review, and by capturing the attitudes and treatment approaches of dermatology specialists. Results: Data from 409 patients with beyondmild psoriasis treated with Cal/BD foam were provided by 120 dermatology specialists from Germany, Spain, and the UK. Cal/BD foam was prescribed as monotherapy for most (58%) patients and was considered to be effective. Cal/BD foam was infrequently used in combination with biologics (7%) in this segment; 26% of patients received Cal/BD foam in combination with a non-biologic systemic treatment. Cal/BD foam prescribers generally use topical agents to bridge the waiting time to non-biologic/biologic systemic treatment, and as an add-on to systemic treatment for residual lesions. Conclusions: In patients with beyond-mild psoriasis, the most commonly prescribed topical medication was Cal/BD foam, which was regarded as an effective treatment. Further research is needed to determine optimal use of Cal/BD foam in these patients.

Data Mining and Meta-Analysis of Psoriasis Based on Association Rules

“…With the treatment, the skin lesions improved, the plaque disappeared, and the degree of vasodilation and function also gradually recovered. The researchers compared the blood vessel diameters of scalp lesions in healthy people, patients with seborrheic dermatitis, and patients with psoriasis through dermoscopy, and found that the diameters of scalp capillaries in the seborrheic dermatitis group and the healthy group were similar [ 41 ]. There was a significant difference between the capillary diameter of the group and the former two, and the vascular bulb was significantly expanded.…”

Beyond-Mild Psoriasis: A Consensus Statement on Calcipotriol and Betamethasone Dipropionate Foam for the Topical Treatment of Adult Patients

“…Recommendation 1B: Cal/BD Foam, Given as Monotherapy, Is Safe and Effective up to 4 weeks for Patients with Beyond-Mild Psoriasis (as Supported by RCTs, Real-World Evidence and Guidelines) Current guidelines recommend the use of topical monotherapy as first-line therapy in localised disease, and advise that improvement in symptoms should be expected within 4 weeks of initiating topical therapy [7,25]. Clinical evidence supports the use of Cal/BD foam as monotherapy in patients with more severe disease/moderate-to-severe psoriasis, due to its efficacy, rapid onset of action and favourable safety profile [14,17,[26][27][28]. For example, in a subgroup analysis of the PSO-ABLE study in patients with moderate-to-severe disease, a higher proportion of patients achieved PASI 75 with Cal/BD foam compared with gel at weeks 4, 8 and 12, and also had superior DLQI scores [17].…”

“…Topical treatments may also be used as a bridge to cover a treatment gap or to control disease flare when, in some healthcare systems, formal approval is required from payers before systemic therapy is initiated or changed [31]. Real-world evidence (RWE) demonstrates that specialists may use topical agents to bridge the waiting time to systemic treatment with a non-biologic (64% of HCPs) or a biologic (63%) [14].…”

“…Patients in the 'grey zone' between mild and severe may be eligible for topical or systemic therapy, or a combination of both. Following a review of the academic literature, three psoriasis specialists, in collaboration with LEO Pharma and a market research company (Cello Health Insight, London, UK), developed the concept of 'beyond-mild' psoriasis to describe this population [14]. The literature review selected studies with the following characteristics: patients with moderate-to-severe disease; N [ 50 patients; treatment either available or with potential to be licensed by the European Medicines Agency.…”

“…The literature review selected studies with the following characteristics: patients with moderate-to-severe disease; N [ 50 patients; treatment either available or with potential to be licensed by the European Medicines Agency. More weight was given to studies with an active comparator (not placebo/vehicle), and informative severity measures and outcomes [14].…”