According to Dr. Mark Lebwohl of Mount Sinai Medical Center in New York, steroid spray followed by eight weeks of treatment with a calcitriol-based ointment was proven effective for controlling plaque psoriasis.

From WebMD:

Three out of four patients with plaque psoriasis had a least a one-grade improvement in disease severity after 12 weeks of treatment with sequential topical therapy, according to interim data from an open-label study.

Four weeks of a steroid spray followed by eight weeks of treatment with a calcitriol-based ointment proved effective for achieving and maintaining disease control, Mark Lebwohl, M.D., of Mount Sinai Medical Center in New York, reported at the American Academy of Dermatology meeting.

“We haven’t had a vitamin D ointment since calcipotriene was taken off the market,” said Dr. Lebwohl. “The calcitriol ointment we used in this study is now available in the U.S., and these results show that it can be used effectively with clobetasol spray to control psoriasis disease activity.”

Topical corticosteroids have formed the basis of therapy for psoriasis since the 1950s. During that time, clinical emphasis has shifted from short-term treatment for disease flares to maintenance therapy for long-term control.

The change in clinical philosophy has given rise to therapeutic strategies involving sequential, combination, and rotational therapy, said Dr. Lebwohl. Topical steroids have remained central to these strategies, but need for a nonsteroidal component of therapy has increased.

In the study, patients began treatment with clobetasol spray twice a day for two weeks. When the severity of psoriasis was clear at that point, the patient was withdrawn. If not, clobetasol treatment continued for another two weeks. After four weeks of treatment with calcitriol ointment, patients whose disease severity had returned to baseline withdrew from the study. After 12 weeks, 73.9% of patients had at least one-grade improvement in overall disease severity.

Tags: calcitriol, clobetasol, Dr. Lebwohl, psoriasis

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