Itching For Relief: The Evidence Of Fixed Dose Calcipotriol Plus Betamethasone Dipropionate Foam For Psoriasis
Abstract
Psoriasis is a chronic immune-mediated skin disease with a variety of morphological presentations, distribution patterns and severities. Psoriasis can have a profound impact on health-related quality of life (HRQoL), almost equal to that seen in patients suffering from cardiovascular disease and cancer. In Canada, it is estimated that approximately 3% of the population suffers from psoriasis, equating to over 1 million people. The most common presentation is ‘mild-to-moderate’ plaque psoriasis characterized by well-defined silver scaly plaques on extensor surfaces. However, classifying severity can be challenging. In 2020, the International Psoriasis Council recommended classifying psoriasis severity with a dichotomous definition: either candidates for topical therapy or candidates for systemic therapy. Regardless of severity, all patients living with psoriasis will need a topical agent as part of their treatment regimen throughout the clinical course of their disease.
References
Møller AH, Erntoft S, Vinding GR, Jemec GB. A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values. Patient Relat Outcome Meas. 2015;6:167–177.
Papp KA, Gniadecki R, Beecker J, et al. Psoriasis Prevalence and Severity by Expert Elicitation. Dermatol Ther (Heidelb). 2021 Jun;11(3):1053-1064. doi: 10.1007/s13555-021-00518-8. Epub 2021 Apr 22. PMID: 33886086; PMCID: PMC8163919.
Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005 Mar;64 Suppl 2(Suppl 2):18-23; discussion ii24-5. doi: 10.1136/ard.2004.033217. PMID: 15708928; PMCID: PMC1766861.
Strober B, Ryan C, Van De Kerkhof P,et al. International Psoriasis Council Board Members and Councilors. Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council. J Am Acad Dermatol. 2020 Jan;82(1):117-122. doi: 10.1016/j. jaad.2019.08.026. Epub 2019 Aug 16. PMID: 31425723.
Stein Gold LF, Kircik LH, Pariser DM. Understanding topical therapies for psoriasis. Cutis. 2019 Apr;103(4S):S8-S12. PMID: 31116805.
Norsgaard H, Kurdykowski S, Descargues P, Gonzalez T, Marstrand T, Dünstl G, Røpke M. Calcipotriol counteracts betamethasone-induced decrease in extracellular matrix components related to skin atrophy. Arch Dermatol Res. 2014 Oct;306(8):719-29. doi: 10.1007/ s00403-014-1485-3. Epub 2014 Jul 16. PMID: 25027750; PMCID: PMC4168021.
Vakirlis E, Kastanis A, Ioannides D. Calcipotriol/betamethasone dipropionate in the treatment of psoriasis vulgaris. Ther Clin Risk Manag. 2008;4(1):141-148. doi:10.2147/tcrm.s1478.
Shttps://health-products. canada.ca/dpd-bdpp/info. do?lang=en&code=94445.
Koo J, Tyring S, Werschler WP, Bruce S, Olesen M, Villumsen J, Bagel J. Superior efficacy of calcipotriene and betamethasone dipropionate aerosol foam versus ointment in patients with psoriasis vulgaris–A randomized phase II study. J Dermatolog Treat. 2016;27(2):120-7. doi: 10.3109/09546634.2015.1083935. Epub 2015 Oct 7. PMID: 26444907; PMCID: PMC4772687.
Paul C, Stein Gold L, Cambazard F, Kalb RE, Lowson D, Bang B, Griffiths CE. Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO-ABLE study. J Eur Acad Dermatol Venereol. 2017 Jan;31(1):119-126. doi: 10.1111/ jdv.13859. Epub 2016 Aug 17. PMID: 27531752; PMCID: PMC6207928.
Lebwohl M, Kircik L, Lacour JP, et al. Twice-weekly topical calcipotriene/ betamethasone dipropionate foam as proactive management of plaque psoriasis increases time in remission and is well tolerated over 52 weeks (PSO-LONG trial). J Am Acad Dermatol. 2021 May;84(5):1269-1277. doi: 10.1016/j.jaad.2020.09.037. Epub 2020 Sep 18. PMID: 32950546.
Wu JJ, Hansen JB, Patel DS, Nyholm N, Veverka KA, Swensen AR. Effectiveness comparison and incremental cost-per-responder analysis of calcipotriene 0.005%/ betamethasone dipropionate 0.064% foam vs. halobetasol 0.01%/ tazarotene 0.045% lotion for plaque psoriasis: a matching-adjusted indirect comparative analysis. J Med Econ. 2020 Jun;23(6):641-649. doi: 10.1080/13696998.2020.1722139. Epub 2020 Mar 2. PMID: 31985301.
Leonardi C, Bagel J, Yamauchi P, Pariser D, Xu Z, Olesen M, Østerdal ML, Stein Gold L. Efficacy and Safety of Calcipotriene Plus Betamethasone Dipropionate Aerosol Foam in Patients With Psoriasis Vulgaris–a Randomized Phase III Study (PSO-FAST). J Drugs Dermatol. 2015 Dec;14(12):1468-77. PMID: 26659941.
Jalili A, Lebwohl M, Stein Gold L et al. Itch relief in patients with psoria-sis: effectiveness of calcipotriol plus betamethasone dipropionate foam. J Eur Acad Dermatol Venereol. 2019;33:709–717.
Griffiths CE, Stein Gold L, Cambazard F, Kalb RE, Lowson D, Møller A, Paul C. Greater improvement in quality of life outcomes in patients using fixed-combination calcipotriol plus betamethasone dipropionate aerosol foam versus gel: results from the PSO-ABLE study. Eur J Dermatol. 2018 Jun 1;28(3):356-363. doi: 10.1684/ejd.2018.3302. PMID: 29952297.