Adherence to topical treatment in psoriasis: a systematic literature review

Devaux, S.; Castela, Ângela; Archier, E.; Gallini, Adeline; Joly, P.; Miséry, Laurent; Aractingi, S.; Aubin, F.; Bachelez, Hervé; Cribier, B.; Jullien, D.; Maître, Michel; Richard, M.‐A.; Jp, Ortonne; Paul, C.

doi:10.1111/j.1468-3083.2012.04525.x

Cited by 169 publications

(183 citation statements)

References 42 publications

(176 reference statements)

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“…Preference data indicate that a greater proportion of patients receiving Cal/BD aerosol foam than Cal/BD gel thought it was more effective, easier to apply and generally preferred it compared with previous topical and systemic therapies. These observations may be important in clinical practice, given that adherence to topical therapy remains a significant issue 9. Previous studies have shown that if patients think a treatment is effective and easy to use they are more likely to be adherent,9, 31 which should lead to better treatment outcomes.…”

Section: Discussionmentioning

confidence: 95%

“…These observations may be important in clinical practice, given that adherence to topical therapy remains a significant issue 9. Previous studies have shown that if patients think a treatment is effective and easy to use they are more likely to be adherent,9, 31 which should lead to better treatment outcomes. Although further studies are needed, these patient preference data suggest that Cal/BD aerosol foam may address some of the current unmet needs of the psoriasis patient population.…”

Section: Discussionmentioning

confidence: 95%

“…Although many patients with mild‐to‐moderate psoriasis are treated with topical therapy alone,6, 7, 8 adherence remains a significant issue as the daily treatment regimen can be cumbersome and time consuming 9. Studies have shown that the type of topical vehicle used can impact on adherence;10, 11 patients prefer a vehicle that is simple and fast to apply, quickly absorbed and non‐greasy 12…”

Section: Introductionmentioning

confidence: 99%

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Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Paul

Gold

Cambazard

et al. 2016

Acad Dermatol Venereol

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167

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BackgroundFixed combination calcipotriol 50 μg/g (Cal) plus betamethasone 0.5 mg/g (BD) foam has been developed as a new treatment option for patients with psoriasis.MethodsThe randomized, parallel‐group, investigator‐blinded Phase III, 12‐week PSO‐ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel. Patients aged ≥18 years with mild‐to‐severe psoriasis were randomized 4:4:1:1 to once‐daily Cal/BD foam, Cal/BD gel, foam vehicle or gel vehicle (NCT02132936). The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician's global assessment of disease severity (i.e. treatment success) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel. Secondary efficacy endpoints included: proportion of patients achieving at least a 75% reduction in modified psoriasis area and severity index (mPASI75), and time to treatment success (TTTS). Safety was monitored throughout.ResultsA total of 463 patients were randomized: Cal/BD foam (n = 185), Cal/BD gel (n = 188), foam vehicle (n = 47), gel vehicle (n = 43); overall completion rate was 90%. Cal/BD foam achieved higher treatment success rates (38% vs. 22%; P < 0.001) and mPASI75 (52% vs. 35%; P < 0.001) by week 4 than Cal/BD gel by week 8. Median TTTS with Cal/BD foam was 6 weeks; this could not be determined for Cal/BD gel as 50% treatment success was not achieved (P < 0.001). Adverse drug reactions were reported in 14 (7.6%) Cal/BD aerosol foam patients and 7 (3.7%) Cal/BD gel patients; all were single events except for itch with Cal/BD aerosol foam (n = 5; 2.7%) and worsening psoriasis with Cal/BD gel (n = 3; 1.6%).ConclusionCal/BD aerosol foam showed significantly greater efficacy after 4 weeks, than 8 weeks of treatment with Cal/BD gel, with similar tolerability.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Paul

Gold

Cambazard

et al. 2016

Acad Dermatol Venereol

Self Cite

167

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“…Adherence is influenced by multiple factors, which can be patient, disease or treatment related 10. Treatment‐related reasons include lack of efficacy, excessive time applying the medication and poor cosmetic characteristics 4. The vehicle used can therefore also impact adherence,11 as patients generally prefer a vehicle that is simple to apply, quickly absorbed and not greasy 12.…”

Section: Introductionmentioning

confidence: 99%

Patients with psoriasis have different preferences for topical therapy, highlighting the importance of individualized treatment approaches: randomized phase IIIb PSO‐INSIGHTFUL study

Papp

et al. 2017

Acad Dermatol Venereol

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BackgroundPoor adherence to topical therapy in psoriasis remains an issue; it is associated with poor clinical outcomes, reduced quality of life and increased costs. Treatment‐related factors leading to poor adherence include lack of efficacy, excessive time applying medication and poor cosmetic characteristics (e.g. slow absorption, greasiness).ObjectiveTo assess the topical treatment attributes that influence patient preference for fixed combination calcipotriol 50 μg/g (Cal) and betamethasone 0.5 mg/g as dipropionate (BD) foam vs. gel, as well as in comparison with the latest topical treatment (LTT) a patient received.Methods PSO‐INSIGHTFUL was a Phase IIIb, prospective, multicentre (Canada/Germany), open‐label, randomized, two‐arm crossover study in patients aged ≥18 years with mild‐to‐severe psoriasis (NCT02310646). Following a washout period of up to 4 weeks, patients were randomized 1 : 1 to once‐daily Cal/BD foam for 1 week, followed by Cal/BD gel for 1 week, or vice versa. Patients completed six questionnaires evaluating patient preferences.ResultsA total of 213 patients were randomized; 118 had received a topical treatment in the previous 3 months. Based on the Subject's Preference Assessment, 50% of patients preferred Cal/BD foam and 50% preferred Cal/BD gel. Based on the Topical Product Usability Questionnaire (TPUQ), overall mean scores were high for both Cal/BD foam and gel, and were often significantly in favour of both products compared with LTT. Greater differences between Cal/BD foam and gel vs. LTT occurred when the previous treatment was an ointment or cream. Cal/BD foam was generally preferred by younger patients (aged 18–39 years), whereas Cal/BD gel tended to be preferred by older patients (aged ≥40 years). Results from other questionnaires were aligned with the TPUQ.ConclusionsPatients with psoriasis have diverse needs and different preferences for topical treatment. This knowledge may help prescribers to choose the right formulation for the right patient, potentially leading to improved adherence and better treatment outcomes.

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“…The stability of two different semisolid formulations that incorporate SD was evaluated. Since the properties of topical formulations have a major impact on patient compliance with treatment (Fouéré, Adjadj, Pawin, 2005;Brown, Rehmus, Kimball, 2006;Devaux et al, 2012), textural and rheological characterization of semisolid formulations were performed. …”

Section: Introductionmentioning

confidence: 99%

Use of solid dispersions to increase stability of dithranol in topical formulations

Estanqueiro

Conceição

Amaral

et al. 2014

Braz. J. Pharm. Sci.

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The present study was planned to improve the stability of dithranol using solid dispersions (SD). Two different SD at a 1:9 ratio of dithranol/excipient were prepared: one of them using glyceryl behenate as excipient and the other using a mixture of argan oil with stearic acid (1:8 ratio) as excipient. Pure dithranol and SD of dithranol were incorporated in an oil-in-water cream and in a hydrophobic ointment in a drug/ dermatological base ratio of 1:10. The physical and mechanical properties of semisolid formulations incorporating the pure drug and the developed SD were evaluated through rheological and textural analysis. To evaluate the stability, L*a*b* color space parameters of SD and semisolid formulations, and pH of hydrophilic formulations were determined at defined times, during one month. Each sample was stored at different conditions namely, light exposure (room temperature), high temperature exposition (37 °C) (protected from light) and protected from light (room temperature). Despite higher values of firmness and adhesiveness, hydrophobic ointment exhibited the best rheological features compared to the oil-in-water cream, namely a shear-thinning behavior and high thixotropy. These formulations have also presented more stability, with minor changes in L*a*b* color space parameters. The results of this study indicate that is possible to conclude that the developed SD contributed to the increased stability of dithranol.Uniterms: Dithranol/stability. Topical formulations/development. Solid dispersions/preparation. Stearic acid. Glyceryl behenate. Argan oil.Este trabalho teve como objetivo aumentar a estabalidade do ditranol através da preparação de dispersões sólidas (DS). Prepararam-se duas DS diferentes em proporção de 1:9 de ditranol/excipiente: em uma das DS utilizou-se beenato de glicerila como excipiente e na outra se utilizou mistura de óleo de argan com ácido esteárico (razão 1:8). Posteriormente, efetuou-se a incorporação de ditranol puro e das DS contendo este fármaco num creme hidrófilo ou óleo-água (O/A) e em pomada hidrófoba, na proporção 1:10 (fármaco ou respetivas DS/base dermatológica). As propriedades físicas e mecânicas das formulações semissólidas incorporando fármaco ou as respetivas DS previamente desenvolvidas, foram avaliadas através da análise do comportamento reológico e das propriedades de textura. Para avaliar a estabilidade, os parâmetros do espaço de cor L*a*b* das DS e das formulações semissólidas e o pH das preparações hidrófilas foram determinados em períodos de tempo definidos, durante um mês para cada amostra armazenada sob diferentes condições, especificamente, exposição à luz (à temperatura ambiente), protegidas da luz à temperatura elevada (37 °C) e protegidas da luz (temperatura ambiente). Embora tenham apresentado valores de firmeza e de adesividade mais elevados, as pomadas hidrófobas apresentaram melhores características reológicas do que os cremes óleo-água. Além disso, as pomadas hidrófobas também apresentaram melhor estabilidade, com pequenas alterações nos parâ...

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Adherence to topical treatment in psoriasis: a systematic literature review

Cited by 169 publications

References 42 publications

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Patients with psoriasis have different preferences for topical therapy, highlighting the importance of individualized treatment approaches: randomized phase IIIb PSO‐INSIGHTFUL study

Use of solid dispersions to increase stability of dithranol in topical formulations

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