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Rapid onset of action of calcipotriol/betamethasone dipropionate cutaneous foam in psoriasis, even in patients with more severe disease
Author(s) -
Pink A.E.,
Jalili A.,
Berg P.,
CalzavaraPinton P.G.,
Cueva Dobao P.,
Thaçi D.,
Torpet M.,
Jensen K.L.,
Segaert S.
Publication year - 2019
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.15398
Subject(s) - medicine , betamethasone dipropionate , calcipotriol , psoriasis , dermatology life quality index , psoriasis area and severity index , plaque psoriasis , dermatology , quality of life (healthcare) , gastroenterology , nursing
Abstract Background The effectiveness of topical therapies in psoriasis is dependent on, amongst other factors, patient adherence. Together with treatment effectiveness and reduction of symptoms, speed of onset and health‐related quality of life ( HRQ oL) are important influencers of adherence. Methods This pooled analysis of three Phase II / III trials evaluated the efficacy of topical fixed‐dose combination calcipotriol 50 μg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/ BD foam) vs. foam vehicle at early timepoints in mild‐to‐severe psoriasis using clinically meaningful modified Psoriasis Area and Severity Index ( mPASI ) and Dermatology Life Quality Index ( DLQI ) targets. Results A greater proportion of Cal/ BD ‐foam‐ vs. foam‐vehicle‐treated patients achieved absolute mPASI targets 0 (15.1% vs. 1.0%), ≤1 (41.4% vs. 5.2%), ≤3 (78.5% vs. 29.2%) and ≤5 (90.2% vs. 62.5%) at week 4 ( P < 0.001; all targets). Significant differences between Cal/ BD ‐foam‐ vs. foam‐vehicle‐treated patients were observed as early as week 1 in those achieving mPASI ≤1 (6.8% vs. 1.5%; P < 0.01), ≤3 (40.4% vs. 22.8%; P < 0.001) and ≤5 (69.7% vs. 50.8%; P < 0.001). In patients with more severe psoriasis (baseline mPASI >10), a greater proportion of Cal/ BD ‐foam‐ vs. foam‐vehicle‐treated patients achieved mPASI ≤1 (20.2% vs. 5.9%; P < 0.05), ≤3 (49.2% vs. 8.8%; P < 0.001) and ≤5 (63.7% vs. 26.5%; P < 0.001) at week 4. In patients with severely impaired HRQ oL (baseline DLQI >10), a greater proportion of Cal/ BD ‐foam‐ vs. foam‐vehicle‐treated patients achieved target DLQI ≤1 or 0 (week 4: DLQI ≤1, 25.0% vs. 4%; P = 0.001; DLQI 0, 17.4% vs. 2.0%; P = 0.006). Conclusion We report rapid onset of action and greater efficacy with Cal/ BD foam vs. foam vehicle, even in patients with more severe psoriasis, manageable with topical treatments. This may support physician management of patient expectations and improve patient adherence, translating into overall topical treatment effectiveness.