Calcipotriol cream combined with twice weekly broad-band UVB phototherapy: a safe, effective and UVB-sparing antipsoriatric combination treatment. The Canadian Calcipotriol and UVB Study Group.
Type:Uv phototherapy Time:2017-10-10 11:16:38Calcipotriol cream combined with twice weekly broad-band UVB phototherapy: a safe, effective and UVB-sparing
antipsoriatric combination treatment. The Canadian Calcipotriol and UVB Study Group.
BACKGROUND:
Calcipotriol has been combined with a number of systemic antipsoriatric treatments, improving efficacy or reducing the
systemic treatment required. Although studies on calcipotriol and UVB have also been performed, there are no data on
the UVB-saving effect of calcipotriol combined with broad-band UVB to reduce overall UVB exposure, while maintaining
efficacy.
OBJECTIVES:
To assess the efficacy and safety of calcipotriol cream (50 microg/g) combined with twice weekly broad-band UVB and to
determine if this treatment would require fewer UVB treatments and lower cumulative UVB irradiance when compared to a
standard 3 times weekly broad-band UVB regime in patients with extensive psoriasis.
METHODS:
This multicentre, prospective, randomised, parallel-group, vehicle-controlled, single-blind (investigator) study
consisted of a 1-week wash-out phase, 12-week treatment phase and 12-week follow-up phase. Broad-band UVB equipment
was standardised and calibrated prior to the study. The UVB starting dose was based on the patient's minimal erythema
dose. Assessments included PASI, extent, severity and investigator and patient's overall assessments of the psoriasis.
RESULTS:
Fewer exposures (12 vs. 19) and less cumulative UVB irradiance (1,570 vs. 5,430 mJ/cm(2)) were required by the
calcipotriol + twice weekly UVB group to achieve 80% reduction in PASI (p < 0.001). Similarly, fewer exposures (22 vs.
25) and less cumulative UVB irradiance (4,147 vs. 9,670 mJ/cm(2)) were required by this group to achieve total
clearance (p < 0.001). There was no difference in the PASI, patient's and investigator's overall assessments and
number of adverse events recorded by either group for both the treatment and follow-up phases.
CONCLUSION:
Calcipotriol cream + twice weekly broad-band UVB phototherapy is an effective and safe antipsoriatric treatment,
resulting in fewer UVB exposures, lower cumulative irradiance and a saving of time.
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