Federico II University Dermatological Clinic, Naples, Italy.
Eur Rev Med Pharmacol Sci. 2022 Mar;26(6):2018-2024. doi: 10.26355/eurrev_202203_28350.
The PSO-LONG trial demonstrated that proactive management of psoriasis based on the regular application of the fixed-dose combination calcipotriol and betamethasone dipropionate (Cal/BD) foam twice a week for 52 weeks prolonged the time to first relapse and reduced the number of relapses, compared with the reactive management. Nevertheless, data about proactive management in clinical practice are still poor. This observational study compares the Cal/BD foam proactive management of psoriasis with the reactive scheme in consecutive patients with localized mild-to-moderate psoriasis. The degree of the skin atrophy was also assessed with dermoscopic and confocal microscopy analyses.
This retrospective observational study was conducted at the Federico II University Dermatological Clinic of Naples in adult patients treated with the fixed-dose combination Cal/BD foam (Enstilar®, Leo Pharma, Ballerup, Denmark) according to either a proactive or a reactive scheme (on-demand treatment). The observation time was 52 weeks.
149 patients were involved. The effectiveness of the proactive therapy was sustained by the significant reduction of the mean number of relapses (p=0.004) and by the significant increase of the median time to relapse (p=0.014) compared to the reactive regimen. Compared to the baseline values, significant improvements in the Psoriasis Area and Severity Index (PASI) score, Investigator Global Assessment (IGA) score, and Skindex-16 index were reported. Dermoscopy and confocal microscopy analyses showed the absence of cutaneous atrophy during the proactive treatment and improved the lesion's appearance.
The proactive regimen represents a valuable therapeutic novelty in treating mild-to-moderate psoriasis.
PSO-LONG 试验表明，与反应性管理相比，基于每周两次规律应用固定剂量钙泊三醇和倍他米松二丙酸酯（Cal/BD）泡沫的主动管理可延长银屑病首次复发的时间并减少复发次数。然而，关于临床实践中主动管理的数据仍然很少。本观察性研究比较了 Cal/BD 泡沫在局部轻度至中度银屑病连续患者中的主动管理与反应性方案。还使用皮肤镜和共聚焦显微镜分析评估皮肤萎缩的程度。
这项回顾性观察性研究在那不勒斯的费德里科二世大学皮肤科诊所进行，研究对象为接受固定剂量联合 Cal/BD 泡沫（Enstilar®，Leo Pharma，Ballerup，丹麦）治疗的成年患者，根据主动或反应性方案（按需治疗）进行治疗。观察时间为 52 周。
共有 149 例患者参与。与反应性方案相比，主动治疗的有效性通过显著减少平均复发次数（p=0.004）和显著增加复发中位时间（p=0.014）得以维持。与基线值相比，报告了银屑病面积和严重程度指数（PASI）评分、研究者全球评估（IGA）评分和 Skindex-16 指数的显著改善。皮肤镜和共聚焦显微镜分析显示，在主动治疗期间不存在皮肤萎缩，并改善了病变的外观。
主动治疗方案代表了治疗轻度至中度银屑病的一种有价值的治疗新方法。
