The Safety and Efficacy of Tazarotene Gel, a Topical Acetylenic Retinoid, in the Treatment of Psoriasis

Krueger, Gerald G.; Drake, Lynn A.; Elias, Peter M.; Lowe, Nicholas J.; Guzzo, Cynthia; Weinstein, Gerald D.; Lew‐Kaya, Deborah A.; Lue, John C.; Sefton, John; Chandraratna, Roshantha A.S.

doi:10.1001/archderm.134.1.57

Cited by 59 publications

(34 citation statements)

References 5 publications

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“…In other study using tazarotene gel 0.05%, the percentage of patients with PASI reduction of ≥75 after 6 weeks of treatment was 45% [26] versus 87.6% after 8 weeks treatment with podophyllin in the present study.…”

Section: Discussionsupporting

confidence: 46%

Podophyllin (10%) Ointment: A New Therapeutic Modality for Psoriasis

Sharquie¹,

Noaimi²,

Al-Janabi³

2013

JCDSA

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Background: There are many topical therapies for the treatment of plaque psoriasis like steroid, dithranol, tar and vitamin D analogues, but none of them is ideal. Most recently, in a pilot study, podophyllin 5% ointment on every other day regimen was as effective as clobetasole 0.05% ointment twice daily. Objective: To reassess the efficacy of a higher concentration of podophyllin (10%) in the treatment of mild psoriasis in comparison with clobetasole using a different regimen. Patients and Methods: This is therapeutic, comparative, placebo-controlled study conducted at the Department of Dermatology-Baghdad Teaching Hospital, during the period of January 2011 -October 2012. Eighty-seven patients with mild plaque-type psoriasis were divided into three groups: Group A (30) patients were treated with podophyllin 10% ointment; Group B (30) patients were treated with clobetasol propionate 0.05% ointment and Group C (27) patients were treated with Vaseline as a placebo control group. All patients were treated on every other day. The efficacy was evaluated every 2 weeks for 8 weeks using PASI score and the local and systemic side effects were recorded. The relapse was recorded after cessation of therapy in those patients who achieved good response during another 8 weeks follow-up period. Results: The patients were 60 (68.9%) males and 27 (31.1%) females (male: female ratio, 2.2:1). Their ages ranged from 18 -62 (36.4 ± 10) years. Their disease duration ranged from 0.1 -40 (7.8 ± 8.5) years. Their baseline PASI score ranged from 1.6 -9.6 (4.4 ± 5.85). At the end of 8 th week of therapy, Group A patients had achieved much higher reduction in PASI score (77.4 ± 14.1) than Group B patients (60.4 ± 27.8), P value = 0.004, and both of them were with statistically and significantly higher PASI reduction than patients in Group C (28 ± 23.4), P value = <0.001. The total relapse rate during 8 weeks follow-up was much lower among Group A treated patients, 20% versus 66.6% in Group B (P-value = 0.002), while the relapse rate was 100% in the Group C patients. Regarding side effects: 3 (10%) patients developed erythema, burning, pain, blistering and hypopigmentationin Group A. No side effects were reported in Groups B nor C patients with no statistically significant difference among the three groups (P = 0.052). Conclusion: Podophyllin 10% ointment was more effective than clobetasole 0.05% ointment on every other day treatment regimen at the end of 8 weeks treatment with no side effects and a much lower relapse rate in treatment of mild plaque-type psoriasis.

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Section: Discussionsupporting

confidence: 46%

Podophyllin (10%) Ointment: A New Therapeutic Modality for Psoriasis

Sharquie¹,

Noaimi²,

Al-Janabi³

2013

JCDSA

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“…Tazarotene cream (0.05 and 0.1%) proved to be effective in the treatment of psoriasis, whilst irritation is a limitation of tazarotene as monotherapy [55]. In placebo-controlled studies, tazarotene proved to induce a substantial reduction of plaque infiltration, desquamation and erythema.…”

Section: Efficacy and Safetymentioning

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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“…Tazarotene was found to normalize acanthosis by inhibiting the proliferation of psoriatic keratinocytes through several molecular mechanisms and also to decrease epidermal inflammation. Clinical responses are seen after 2 weeks with significant clearing after 6 to 12 weeks of treatment [40]. Topically applied, tazarotene has a low potential for systemic adverse effects but it can be topically strongly irritative.…”

Section: Psoriasis and Related Disordersmentioning

confidence: 99%

Retinoids – Which Dermatological Indications Will Benefit in the Near Future?

Zouboulis¹

2001

Skin Pharmacol Physiol

119

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Retinoids are compounds with pleiotropic functions and a relatively selective targeting of certain skin structures. They are vitamins, because retinol (vitamin A) is not synthesized in the body and must be derived from diet, but also hormones with intracrine activity, because retinol is transformed into molecules that bind to nuclear receptors, exhibit their activity, and are subsequently inactivated. Retinoids exert their effects on target cells by binding and activating nuclear retinoid receptors. Retinoid receptors bind their ligands in form of dimers. Heterodimers can be formed between two different retinoid receptor molecules but also between retinoid X receptors and the vitamin D receptor as well as the triiodothyronin receptor. This fact indicates complex interactions between retinoids and further hormonal signal transduction molecules. Interaction of retinoid receptors with transcriptional factors activated by other signal transduction mechanisms, e.g. AP-1, may provide dissociation of the retinoid effects. Retinoids can exhibit agonistic activity but also be neutral antagonists and inverse agonists. Topical and oral retinol, tretinoin, isotretinoin, and bexarotene, topical alitretinoin, retinaldehyde, motretinide, adapalene, tazarotene, and systemin acitretin compose the list of launched retinoids. Psoriasis and related disorders, congenital disorders of keratinization, acne, photoaging and hypovitaminosis A are classical approved indications of retinoid treatment, whereas cutaneous T-cell lymphoma, AIDS-associated Kaposi’s sarcoma, acute promyelocytic leukemia and actinic lentigines were currently confirmed. In addition, retinoids have been successfully used in several other dermatoses, e.g. epithelial precanceroses and tumors, seborrhea, rosacea and acneiform dermatoses, lichen planus, eosinophilic folliculitis, condylomata accuminata, lichen sclerosus and atrophicus. Highly receptor selective molecules, retinoic acid receptor-β-inducers, AP-1 complex antagonists, and inverse agonists will be probably lead the retinoid development in the near future. New, more effective and less toxic retinoids, alone or in combination with other drugs and new delivery systems may provide therapeutic solutions for benign and malignant proliferative skin diseases, such as psoriasis and non-melanoma tumors, cancer chemoprevention and differentiation therapy.

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The Safety and Efficacy of Tazarotene Gel, a Topical Acetylenic Retinoid, in the Treatment of Psoriasis

Abstract: To determine the safety and efficacy of topically applied tazarotene gel in the treatment of mild to moderate psoriatic plaques.Design: Two multicenter, double-blind, randomized studies of 6-and 8-week duration, with an 8-week follow-up in the second study.

Cited by 59 publications

References 5 publications

Podophyllin (10%) Ointment: A New Therapeutic Modality for Psoriasis

Podophyllin (10%) Ointment: A New Therapeutic Modality for Psoriasis

The Topical Treatment of Psoriasis

Retinoids – Which Dermatological Indications Will Benefit in the Near Future?

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