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Background  Plaque psoriasis has significant impact on patients’ quality of life. Topical therapy is considered the treatment mainstay for mild‐to‐moderate disease according to guidelines. Calcipotriol/betamethasone dipropionate (Cal/ BD ) [0.005%/0.05%] aerosol foam is indicated for psoriasis vulgaris treatment in adults. Cal/ BD  foam trials demonstrated improved efficacy and similar safety in this population. Psoriasis treatment is complicated by the broad range of disease presentation, variability and therapeutic options; particularly decisions on transition from topical to non‐biologic systemic treatment are difficult. Assessing comparative effectiveness of treatment options provides meaningful value to treatment decisions.    Objective  To compare efficacy of Cal/ BD  foam individual patient data from pooled trials with efficacy of non‐biologic systemic treatments based on aggregated patient characteristics and treatment outcomes.    Methods  Individual data from four Cal/ BD  foam trials in 749 psoriasis patients were pooled to conduct matching‐adjusted indirect comparisons. Literature review identified non‐biologic systemic treatment trials where methods, populations and outcomes align with Cal/ BD  foam trials. Of 3090 screened publications, four studies of apremilast, methotrexate, acitretin or fumaric acid esters ( FAE ) were included.    Results  After baseline matching, patients treated with 4 weeks of Cal/ BD  foam had greater Physician's Global Assessment 0/1 response compared to those treated with 16 weeks of apremilast (52.7% vs. 30.4%;  P  < 0.001). Patients treated with Cal/ BD  foam had significantly greater Psoriasis Area and Severity Index ( PASI ) 75 response at Week 4 compared to 16 weeks of apremilast treatment (51.1% vs. 21.6%;  P  < 0.001). Cal/ BD  foam patients demonstrated significantly greater  PASI  75 response improvements at Week 4 vs. 12 weeks of methotrexate (50.8% vs. 33.5%;  P  < 0.001) or acitretin (50.9% vs. 31.7%;  P  = 0.009), and comparable response to  FAE  (42.4% vs. 47.0%;  P  = 0.451).    Conclusions  Despite recent treatment advances, unmet needs for psoriasis patients remain. Cal/ BD  foam offers improved efficacy in baseline matched psoriasis patients compared to apremilast, methotrexate or acitretin, and comparable efficacy to  FAE .

journal of the european academy of dermatology and venereology

Calcipotriol plus betamethasone dipropionate aerosol foam vs. apremilast, methotrexate, acitretin or fumaric acid esters for the treatment of plaque psoriasis: a matching‐adjusted indirect comparison