Paul Carle, Leonardi Craig, Menter Alan, Reich Kristian, Gold Linda Stein, Warren Richard B, Møller Anders, Lebwohl Mark
Paul Sabatier University and Larrey Hospital, Toulouse, France.
Saint Louis University School of Medicine, St. Louis, MO, USA.
Am J Clin Dermatol. 2017 Jun;18(3):405-411. doi: 10.1007/s40257-017-0258-0.
Fixed-combination calcipotriol 50 μg/g plus betamethasone 0.5 mg/g (Cal/BD) aerosol foam is a new topical treatment for psoriasis. Although moderate-to-severe psoriasis is typically treated with systemic/biologic therapies, a topical treatment that is efficacious in these patients may be a significant cost-saving alternative to systemic therapy.
The objective of this study was to assess the response to Cal/BD foam and gel in patients with moderate-to-severe psoriasis enrolled in the phase III, 12-week PSO-ABLE study.
Patients eligible for this analysis had moderate-to-severe psoriasis, defined by the 'Rule of Tens': body surface area ≥10% or Psoriasis Area and Severity Index (PASI) [excluding head; modified PASI (mPASI)] >10 or Dermatology Life-Quality Index >10. Endpoints included: proportion of patients achieving mPASI75 or mPASI90; change in body surface area; proportion of patients clear/almost clear with a ≥2 grade improvement (i.e., treatment success); change in Dermatology Life-Quality Index.
Seventy-seven Cal/BD foam patients and 82 gel patients had moderate-to-severe psoriasis. A greater proportion achieved mPASI75 and mPASI90 with Cal/BD foam than gel at weeks 4, 8, and 12 (57.1 vs. 35.4%; p = 0.006 and 15.6 vs. 12.2% at week 12, respectively); overall reduction in mPASI from baseline to week 12 was 64% with the foam vs. 51% with the gel. Overall reduction in body surface area at week 12 was 50% with the foam and 39% with the gel. Treatment success rates were higher with the Cal/BD foam than the gel at weeks 1, 2, 4, 8 (p = 0.0089), and 12, and a greater proportion of foam patients achieved a Dermatology Life-Quality Index score of 0/1 at weeks 4 (p = 0.004), 8, and 12 (p = 0.001).
Cal/BD foam can be considered as a treatment option in some patients with moderate-to-severe psoriasis who are potential candidates for systemic therapy. CLINICALTRIALS.
NCT02132936.
卡泊三醇50μg/g加倍他米松0.5mg/g(Cal/BD)气雾剂泡沫是一种治疗银屑病的新型局部用药。尽管中重度银屑病通常采用全身/生物疗法治疗,但对这些患者有效的局部治疗可能是一种比全身治疗显著节省成本的替代方法。
本研究的目的是评估参加III期、为期12周的PSO-ABLE研究的中重度银屑病患者对Cal/BD泡沫和凝胶的反应。
符合本分析条件的患者患有中重度银屑病,根据“十法则”定义:体表面积≥10%或银屑病面积和严重程度指数(PASI)[不包括头部;改良PASI(mPASI)]>10或皮肤病生活质量指数>10。终点包括:达到mPASI75或mPASI90的患者比例;体表面积变化;清除/几乎清除且改善≥2级(即治疗成功)的患者比例;皮肤病生活质量指数变化。
77名使用Cal/BD泡沫的患者和82名使用凝胶的患者患有中重度银屑病。在第4、8和12周时,使用Cal/BD泡沫达到mPASI75和mPASI90的患者比例高于使用凝胶的患者(分别为57.1%对35.4%;p = 0.006,第12周时为15.6%对12.2%);从基线到第12周,泡沫组mPASI总体降低64%,凝胶组为51%。第12周时,泡沫组体表面积总体降低50%,凝胶组为39%。在第1、2、4、8(p = 0.0089)和12周时,Cal/BD泡沫的治疗成功率高于凝胶,并且在第4(p = 0.004)、8和12周(p = 0.001)时,使用泡沫的患者中有更大比例的皮肤病生活质量指数评分为0/1。
对于一些可能适合全身治疗的中重度银屑病患者,Cal/BD泡沫可被视为一种治疗选择。临床试验。
NCT02132936。