Topical calcipotriol combined with phototherapy for psoriasis. The results of two randomized trials and a review of the literature. Calcipotriol-UVB Study Group.

Type:Uv phototherapy   Time:2017-10-18 10:54:36
Topical calcipotriol combined with phototherapy for psoriasis. The results of two randomized trials and a review of 
the literature. Calcipotriol-UVB Study Group.
BACKGROUND:
Calcipotrial has a well-documented effect in the treatment of psoriasis.
OBJECTIVE:
To confirm the beneficial effect of the combination of calcipotriol and UVB and to demonstrate that the combination is 
safe and well tolerated.
METHODS:
Data from two randomized right/left studies were analysed. Patients included in the studies had chronic stable 
plaque-type psoriasis with symmetrical lesions on the arms, the legs and/or the trunk. In one study, 101 patients were 
treated with calcipotriol on one side and calcipotriol + UVB on the other side of the body (open study). In the other 
study, 77 patients were treated with calcipotriol + UVB on one side and vehicle + UVB on the other side of the body 
(double-blind study). Calcipotriol ointment, 50 microg/g, was applied twice daily and UVB 3 times weekly for 8 weeks. 
UVB was increased from 0.7 MED before treatment in rapid steps up to the erythema threshold.
RESULT:
In both treatment series the therapeutic effect of the combination of calcipotriol and UVB was enhanced as compared to 
calcipotriol alone and UVB alone. In the first series there was a significant reduction of the psoriasis area and 
severity index (PASI) with the combination after 2 weeks as compared to calcipotriol alone. At the end of treatment 
significantly more sides were cleared after calcipotriol + UVB than after calcipotriol alone. In the other series 
there was a significantly faster onset of improvement on the sides treated with calcipotriol + UVB than on those 
treated with vehicle + UVB. After 2 weeks there was a significant difference in PASI in favour of calcipotriol + UVB. 
At the end of treatment, however, there was no difference between the treatments. There was a similar adverse event 
profile with either treatment. The addition of UVB to calcipotriol did not alter the tolerability or safety of 
topically applied calcipotriol.
CONCLUSIONS:
The result indicates a beneficial effect of combining calcipotriol and phototherapy. The findings are compared to 
other published studies.
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