Betamethasone dipropionate in optimized vehicle. Intermittent pulse dosing for extended maintenance treatment of psoriasis

Katz, Harry Irving

doi:10.1001/archderm.123.10.1308

Cited by 29 publications

(17 citation statements)

References 8 publications

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“…There is a perception of tachyphylaxis with long-term corticosteroid use [13]. However, studies have shown that intermittent use of topical corticosteroids kept psoriasis in remission for 4 months in 75% of patients [14], was clinically beneficial for up to 6 months [15], and was an efficacious maintenance therapy when used for 12 weeks [16]. A study investigating the clinical incidence of corticosteroid tachyphylaxis found no evidence of it after 12 weeks of continuous corticosteroid use [17].…”

Section: Discussionmentioning

confidence: 99%

Efficacy Results of a 52-Week, Randomised, Double-Blind, Safety Study of a Calcipotriol/Betamethasone Dipropionate Two-Compound Product (Daivobet®/Dovobet®/Taclonex®) in the Treatment of Psoriasis Vulgaris

et al. 2006

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Background: The calcipotriol/betamethasone dipropionate two-compound product is safe and effective in the short-term treatment of psoriasis. Objective: The primary objective was to investigate the safety of two treatment regimens involving use of the two-compound product over 52 weeks. The efficacy results are presented here. Methods: Six hundred and thirty-four patients were randomised double-blind to treatment (once daily, when required) with either: 52 weeks of two-compound product (two-compound group), 52 weeks of alternating 4-week periods of two-compound product and calcipotriol (alternating group), or 4 weeks of two-compound product followed by 48 weeks of calcipotriol (calcipotriol group). Results: There was a trend towards a difference between treatments from the overall treatment effect for the percentage of satisfactory responses for each patient during the study (p = 0.071). This appeared to be due to the comparison of the two-compound and calcipotriol groups (p = 0.025). Conclusion: There was a trend towards the efficacy of the two-compound product used for up to 52 weeks being better than that of 4 weeks of the two-compound product followed by 48 weeks of calcipotriol.

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Section: Discussionmentioning

confidence: 99%

Efficacy Results of a 52-Week, Randomised, Double-Blind, Safety Study of a Calcipotriol/Betamethasone Dipropionate Two-Compound Product (Daivobet®/Dovobet®/Taclonex®) in the Treatment of Psoriasis Vulgaris

et al. 2006

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“…A recent single-center pilot study reported the success ful long-term use of ABD ointment when applied by pso riasis patients on an intermittent (pulse dose) treatment regimen for an extended time period (up to 90 days) in order to maintain disease remission [5], The results are now being reported for a second clinical trial in which pso riasis patients continued intermittent maintenance ther apy with ABD for up to 180 days (6 months). Mainte nance therapy has also been referred to as 'weekend ther apy' because many patients considered weekends to be the most convenient times for treatment application.…”

Section: Introductionmentioning

confidence: 99%

Intermittent Corticosteroid Maintenance Treatment of Psoriasis: A Double-Blind Multicenter Trial of Augmented Betamethasone Dipropionate Ointment in a Pulse Dose Treatment Regimen

et al. 1991

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Ninety psoriasis patients, who were either completely cleared of or manifested only a minimal presence of disease signs following 3–4 weeks of twice daily treatment with augmented betamethasone dipropionate (ABD) ointment 0.05%, were enrolled in this multicenter, double-blind, placebo-controlled study. The study was designed to determine if an intermittent pulse dose regimen of ABD ointment could safely and effectively maintain a remission disease status when treatment was applied in three consecutive applications 12 h apart, once a week for a maximum treatment period of 6 months. The disease of 60% of the patients in the active treatment group was successfully controlled for 6 months, while 80% of the placebo-treated patients experienced exacerbation of disease signs. No serious local or systemic treatment-related adverse experiences were reported. ABD ointment 0.05% when applied using the intermittent treatment regimen described here, was shown to be a clinically beneficial and well-tolerated method of long-term (up to 6 months) maintenance therapy for psoriasis patients.

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“…The efficacy of a corticosteroid is fast; in general, within 2 weeks the maximal efficacy is expressed. For example, Katz et al [47] reported an 86% or greater improvement of psoriasis severity in 38 out of 59 patients following 2 weeks of twice daily treatment with betamethasone dipropionate. A once daily schedule is as effective as a twice daily schedule [48].…”

Section: Efficacy and Side-effectsmentioning

confidence: 99%

“…Intermittent applications may provide an opportunity for long-term management. Betamethasone dipropionate ointment 0.05% was applied 3 times during the weekend and compared with the vehicle only, following a successful treatment of twice daily betamethasone during 2 weeks [47]. In 74% of the patients using the corticosteroid and in 21% of the patients using the placebo, the remission was maintained for another 12 weeks.…”

Section: Long-term Safety and Efficacymentioning

confidence: 99%

The Topical Treatment of Psoriasis

Kerkhof

Vissers

2003

Skin Pharmacol Physiol

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According to the patients, improvement of efficacy, long-term safety and improvement of compliance are needed. The topical treatment has been innovated during the last decade. Most important are the introduction of two new classes of treatments: topical vitamin D₃ analogues and the retinoid tazarotene. To what extent, however, have we achieved developments which are in line with the needs as expressed by the patients? Improved efficacy has been realized by successful combinations of topical treatments. In particular, the combinations of dithranol, vitamin D₃ and tazarotene with a topical corticosteroid proved to be very effective with a reduced profile of side-effects. The efficacy of vitamin D₃ analogues and tazarotene is such that the efficacy of a potent corticosteroid (betamethasone-17-valerate) is approached; calcipotriol even showed an efficacy which is at least as good as this corticosteroid. The long-term safety of new compounds has been evaluated for at least 12 months in large studies. Remarkably for corticosteroids such information is available for only 12 weeks. However, intermittent applications of a topical corticosteroid in combination with another topical treatment provide an effective and safe long-term control of psoriasis. Compliance is a conditio sine qua non for an effective topical treatment. Important progress has been made to increase compliance. Short-contact dithranol has been popularized as an ambulatory treatment which is a highly effective approach as a care instruction programme. Formulations which are better from a cosmetical point of view have been developed for various topical treatments. Reduction of the frequency of applications proved to be possible for most treatments. Once daily applications for corticosteroids, vitamin D₃ analogues and retinoids have been developed, and intermittent applications, a few times per week, are possible for corticosteroids, which proved to be very effective with a reduced profile of side-effects, and are also developed for dithranol.

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Betamethasone dipropionate in optimized vehicle. Intermittent pulse dosing for extended maintenance treatment of psoriasis

Cited by 29 publications

References 8 publications

Efficacy Results of a 52-Week, Randomised, Double-Blind, Safety Study of a Calcipotriol/Betamethasone Dipropionate Two-Compound Product (Daivobet®/Dovobet®/Taclonex®) in the Treatment of Psoriasis Vulgaris

Efficacy Results of a 52-Week, Randomised, Double-Blind, Safety Study of a Calcipotriol/Betamethasone Dipropionate Two-Compound Product (Daivobet®/Dovobet®/Taclonex®) in the Treatment of Psoriasis Vulgaris

Intermittent Corticosteroid Maintenance Treatment of Psoriasis: A Double-Blind Multicenter Trial of Augmented Betamethasone Dipropionate Ointment in a Pulse Dose Treatment Regimen

The Topical Treatment of Psoriasis

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