Comparison of calcipotriol monotherapy and a combination of calcipotriol and betamethasone valerate after 2 weeks' treatment with calcipotriol in the topical therapy of psoriasis vulgaris: a multicentre, double‐blind, randomized study

Abstract

A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol and betamethasone valerate after previous treatment with calcipotriol alone was more effective than the continuation of the monotherapy with calcipotriol, especially in 'low responders'. Patients (n = 169) with the clinical diagnosis 'chronic plaque-type psoriasis' were treated twice daily for 2 weeks with calcipotriol, followed by a 4-week treatment with calcipotriol monotherapy in 87 patients or combined calcipotriol/betamethasone valerate in 82 patients; all patients were followed for 8 weeks. The psoriasis area and severity index (PASI) was used to compare the two treatment groups. The overall therapeutic result was also assessed by the investigators and patients. The combination therapy was more effective, as assessed by all evaluated variables; moreover, patients showing insufficient response to calcipotriol alone after 2 weeks showed a regression of psoriatic lesions using the combination regimen. Thus, the combination of calcipotriol and topical steroids is recommended as the therapy of first choice for patients who do not respond well to treatment with 2 weeks of calcipotriol alone. Furthermore, this combination reduces the hazards associated with the long-term use of topical corticosteroids (atrophy and rebound) as well as the irritation associated with calcipotriol.

Vitamin D Therapy in Inflammatory Bowel Diseases: Who, in What Form, and How Much?

“…Although these compounds have not been assayed in the treatment of IBD, they were shown to be effective in small open label trials in psoriasis and rheumatoid arthritis. [132][133][134][135] Heliotherapy also increases serum vitamin D concentrations. Exposure of a human body in a bathing suit to one minimal erythema dose of sunlight has been reported to be equivalent to ingesting about 10 000-25 000 IU of vitamin D. 136 In a single case report, a CD patient exposed to a tanning bed (UVB radiation 290-315 nm) while wearing a one-piece bathing suit for 10 minutes per day, 3 times per week for 4 weeks experienced an increase in serum 25(OH) D concentration from 7 to 32 ng/mL.…”

Treatment of Psoriasis Vulgaris with Calcipotriol Betamethasone Dipropionate Combination Followed by Calcipotriol and Assessment of the Adjuvant Basic Use of Urea-Based Emollients

“…Treatment with the combination ointment gives relevant advantages also in terms of patient's compliance, thanks to the once-daily application, quality oflife parameters and tolerability profile (5-10). The use of combination product may reduce the risk of adverse events associated with the long-term use of corticosteroid monotherapy (atrophy and rebound) as well as the irritation associated with calcipotriol (18,21,22).…”

Cost-Effectiveness Model of Topical Treatment of Mild to Moderate Psoriasis Vulgaris in Germany

“…The efficacy is as high as moderately potent steroids [4, 9]. The combination of calcipotriol with steroids further increases the effectiveness of the therapy, due to synergistic effects of the drugs [11,12,13,14,15]. The once daily application of calcipotriol and betamethasone dipropionate as a 2-compound product could offer an even higher effectiveness and cost-effectiveness compared to a twice daily application of the respective compounds, due to a higher compliance, enhanced synergistic effects and lower treatment costs.…”

“…Betamethasone dipropionate, a group III corticosteroid, acts via a glucocorticoid receptor and suppresses inflammation and hyperproliferation [10]. Several studies have shown that the combination of these 2 reagents has synergistic or additive effects and is better tolerated than either monotherapy [11,12,13,14,15]. In addition, the long-term safety of a fix calcipotriol/betamethasone dipropionate combination (Daivobet®/Dovobet®/Taclonex®) has been evaluated positively in several studies [16,17,18,19].…”