Optimal maintenance treatment with calcipotriol/betamethasone dipropionate gel in Korean patients with psoriasis vulgaris: a multicentre randomized, controlled clinical trial

J Eur Acad Dermatol Venereol. 2017 Mar;31(3):483-489. doi: 10.1111/jdv.13865. Epub 2016 Oct 10.

Abstract

Background: There is a lack of response data for topical treatments for psoriasis vulgaris in Asian patients.

Objectives: To determine the optimal maintenance regimen for topical treatment with calcipotriol monohydrate/betamethasone dipropionate gel in Korean patients with psoriasis vulgaris, by comparing the efficacy of three 8-week maintenance regimens.

Methods: This was a multicentre, prospective, randomized, controlled, parallel-group, open-label, phase 4 clinical trial, conducted in South Korea. Patients with psoriasis vulgaris on the limbs/trunk received once-daily treatment with calcipotriol monohydrate (50 μg/g)/betamethasone dipropionate (500 μg/g) gel for 8 weeks (induction phase). Responders (defined as an Investigator's Global Assessment of Disease Severity (IGA) grade of 'clear' or 'almost clear') were then randomized to receive 8 weeks' maintenance treatment with Xamiol® gel once daily as needed [pro re nata (PRN Group)], once daily every day (Continuous group), or twice weekly - on Saturday and Sunday (Weekend group). The primary endpoint was the percentage of IGA responders at week 16.

Results: At the end of the induction phase, 62.18% of patients were IGA responders. At the end of the maintenance phase (week 16), the responder rate was 63.89% for the PRN group, 67.5% for the Continuous group and 31.43% for the Weekend group. The PRN and Continuous groups were statistically superior to the Weekend group (P = 0.0109 and P = 0.0015), but the PRN and Continuous groups did not differ statistically. The incidence of adverse events did not differ significantly between the groups.

Conclusion: Among Korean patients with psoriasis vulgaris, maintenance treatment with calcipotriol monohydrate/betamethasone dipropionate using a continuous daily regimen or an 'as needed' daily regimen provided similar efficacy, whereas a twice-weekly regimen was significantly less efficacious than either of these regimens.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Betamethasone / administration & dosage
  • Betamethasone / adverse effects
  • Betamethasone / analogs & derivatives*
  • Calcitriol / administration & dosage
  • Calcitriol / adverse effects
  • Calcitriol / analogs & derivatives*
  • Dermatologic Agents / administration & dosage*
  • Dermatologic Agents / adverse effects
  • Drug Administration Schedule
  • Drug Combinations
  • Female
  • Gels
  • Humans
  • Induction Chemotherapy
  • Maintenance Chemotherapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Pruritus / chemically induced
  • Psoriasis / drug therapy*
  • Remission Induction
  • Republic of Korea
  • Severity of Illness Index

Substances

  • Dermatologic Agents
  • Drug Combinations
  • Gels
  • betamethasone dipropionate, calcipotriol drug combination
  • Betamethasone
  • Calcitriol