An innovation in topical therapy : Insights from international dermatologists

Topical therapies are appropriate for most patients with psoriasis. These therapies frequently are used as first-line agents for mild and moderate disease and as an adjuvant to phototherapy or systemic treatment. In Europe, vitamin D 3 analogues (eg, calcipotriene) are preferred as first-line therapies and often are used in combination with potent topical corticosteroids. Because calcipotriene and corticosteroids have different mechanisms of action, superior efficacy and reduced side effects can be achieved by their combined use; however, chemical incompatibility prevents combined application. This incompatibility has been overcome by the recent development of a stable formulation of calcipotriene and betamethasone dipropionate. In 7 clinical trials, more than 3000 subjects received once-daily or twice-daily treatment with the 2-compound ointment for 4- to 52-week periods. The overall results indicate that the 2-compound ointment elicits rapid and substantial reductions in Psoriasis Area and Severity Index (PASI) scores. The treatment also is well-tolerated.