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Reformulations of well‐known active ingredients in the topical treatment of psoriasis vulgaris can improve clinical outcomes for patients
Author(s) -
Iversen L.,
Dauden E.,
Segaert S.,
Freeman K.,
Magina S.,
Rigopoulos D.,
Thaci D.
Publication year - 2017
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.14277
Subject(s) - medicine , calcipotriol , psoriasis , clinical trial , dermatology , clobetasol propionate , betamethasone dipropionate , randomized controlled trial , plaque psoriasis , surgery
Although the majority of patients with psoriasis vulgaris are treated exclusively with topical therapies, research to develop more effective topical therapies that are associated with higher patient satisfaction has lagged behind the development of systemic agents. The aim of this literature review was to determine whether there is documented evidence that applying an innovative approach to improving the formulation of active ingredients commonly used in the topical treatment of psoriasis can have a positive effect on clinical outcomes and patient‐reported outcomes ( PRO s). The Embase and PubMed databases were searched for articles published between 2001 and 2016 that made direct head‐to‐head comparisons of different formulations of an active pharmaceutical ingredient ( API ), focusing on clinical outcomes and PRO s. In total, 22 publications on API s or API combinations met the eligibility criteria (19 head‐to‐head clinical trials, one pooled analysis, one health‐economic modelling study and one systematic review). Significant clinical benefit associated with the use of a reformulated API over an older formulation was reported in three trials of clobetasol propionate, one trial of calcipotriol, three trials of betamethasone and five trials/pooled analyses of calcipotriol/calcipotriene + betamethasone dipropionate (Cal/ BD ) formulations. Significantly improved PRO s associated with the use of a reformulated API over an older formulation were reported in three trials of clobetasol propionate, one trial of betamethasone valerate and two trials of Cal/ BD formulations. These results demonstrate that the innovative reformulation of API s used in the treatment of psoriasis can produce therapies that attain significantly improved clinical outcomes and PRO s. This suggests that improvement in topical therapy for psoriasis need not only to be achieved by the identification of new targets and the development of new API s, but that improvement in the vehicle used to deliver existing API s has the potential to result in significant clinical and patient benefits.