Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis

Harshal Mahajan; Gaurav Deshmukh; Dhiraj Dhoot; Rashmi Mamadi; Hanmant Barkate

doi:doi:10.11648/j.ijcd.20200302.13

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Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis

Harshal Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Rashmi Mamadi, Hanmant Barkate

Published in International Journal of Clinical Dermatology (Volume 3, Issue 2)

Received: 29 October 2020 Accepted: 9 November 2020 Published: 19 November 2020

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Abstract

Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.

Published in	International Journal of Clinical Dermatology (Volume 3, Issue 2)
DOI	10.11648/j.ijcd.20200302.13
Page(s)	28-31
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Psoriasis, Calcitriol, Calcipotriol, Topical Corticosteroid, PASI, PGAS

References

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[2]	Saraceno R, Faleri S, Chimenti S. Calcitriol in the Management of Moderate to Severe Plaque Psoriasis. Clinical Medicine Therapeutics 2009: 1 1629–1639.
[3]	Hendriks A, Keijsers R, De Jong E, et al. Efficacy and safety of combinations of first-line topical treatments in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013; 27 (8): 931-51.
[4]	Yan R, Jiang S, Wu Y, et al. Topical calcipotriol/betamethasone dipropionate for psoriasis vulgaris: A systematic review. Indian J Dermatol Venereol Leprol 2016; 82: 135-44.
[5]	Langner A, Stapor W, Ambroziak M. Efficacy and tolerance of topical calcitriol 3 μg g – 1 in psoriasis treatment: a review of our experience in Poland. Br J Dermatol 2001; 144: 11-6.
[6]	Hutchinson PE, Marks R, White J. The efficacy, safety and tolerance of topical calcitriol 3 μg/g ointment in the treatment of plaque psoriasis: a comparison with short-contact dithranol. Dermatology 2000; 201: 139-45.
[7]	Abramovits M. Calcitriol 3 microg/g ointment: an effective and safe addition to the armamentarium in topical psoriasis therapy. Dermatol. 2009; 8 (8): s17-22.
[8]	Kircik L. Efficacy and safety of topical calcitriol 3 microg/g ointment, a new topical therapy for chronic plaque psoriasis. J Drugs Dermatol. 2009; 8 (8): s9-16.
[9]	de Arruda L, de Moraes A. The impact of psoriasis on quality of life. Br J Dermatol 2001; 144 (58): 33–36.
[10]	Krueger G, Koo J, Lebwohl M et al. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol 2001; 137: 280–284.
[11]	Fouéré S, Furtado T. How patients experience psoriasis: results from a European survey. J Eur Acad Dermatol Venereol 2005; 19 (3): 2–6.
[12]	Lebwohl M. Topical application of calcipotriene and corticosteroids: combination regimens. J Am Acad Dermatol 1997; 37 (3): S55-S8.
[13]	Ruzicka T, Lorenz B. Comparison of calcipotriol monotherapy and a combination of calcipotriol and betamethasone valerate after 2 weeks’ treatment with calcipotriol in the topical therapy of psoriasis vulgaris: a multicentre, double blind, randomized study Br J Dermatology 1998; 138: 254-8.
[14]	Koo J, Blum RR, Lebwohl M. A randomized, multicenter study of calcipotriene ointment and clobetasol propionate foam in the sequential treatment of localized plaque-type psoriasis: short- and long-term outcomes. J Am Acad Dermatol 2006; 55: 637–641.
[15]	Katoh N, Kishimoto S. Combination of calcipotriol and clobetasol propionate as a premixed ointment for the treatment of psoriasis. Eur J Dermatol 2003; 13: 382–384.
[16]	Lebwohl M, Siskin SB, Epinette W et al. A multicenter trial of calcipotriene ointment and halobetasol ointment compared with either agent alone for the treatment of psoriasis. J Am Acad Dermatol 1996; 35: 268–269.
[17]	Lahfa M, Mrowietz U, Koenig M, et al. Calcitriol ointment and clobetasol propionate cream: a new regimen for the treatment of plaque psoriasis. Eur J Dermatol. 2003; 13 (3): 261-5.
[18]	Robinson A, Kardos M, Kimball A. Physician Global Assessment (PGA) and Psoriasis Area and Severity Index (PASI): why do both? A systematic analysis of randomized controlled trials of biologic agents for moderate to severe plaque psoriasis. J Am Acad Dermatol. 2012; 66 (3): 369-75.
[19]	Ortonne J, Humbert P, Nicolas J, et al. Intra-individual comparison of the cutaneous safety and efficacy of calcitriol 3 lg g) 1 ointment and calcipotriol 50 lg g) 1 ointment on chronic plaque psoriasis localized in facial, hairline, retroauricular or flexural areas. British Journal of Dermatology 2003; 148: 326–333.
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APA Style

Harshal Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Rashmi Mamadi, Hanmant Barkate. (2020). Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. International Journal of Clinical Dermatology, 3(2), 28-31. https://doi.org/10.11648/j.ijcd.20200302.13

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ACS Style

Harshal Mahajan; Gaurav Deshmukh; Dhiraj Dhoot; Rashmi Mamadi; Hanmant Barkate. Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. Int. J. Clin. Dermatol. 2020, 3(2), 28-31. doi: 10.11648/j.ijcd.20200302.13

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AMA Style

Harshal Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Rashmi Mamadi, Hanmant Barkate. Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. Int J Clin Dermatol. 2020;3(2):28-31. doi: 10.11648/j.ijcd.20200302.13

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@article{10.11648/j.ijcd.20200302.13,
  author = {Harshal Mahajan and Gaurav Deshmukh and Dhiraj Dhoot and Rashmi Mamadi and Hanmant Barkate},
  title = {Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis},
  journal = {International Journal of Clinical Dermatology},
  volume = {3},
  number = {2},
  pages = {28-31},
  doi = {10.11648/j.ijcd.20200302.13},
  url = {https://doi.org/10.11648/j.ijcd.20200302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20200302.13},
  abstract = {Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.},
 year = {2020}
}

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TY  - JOUR
T1  - Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis
AU  - Harshal Mahajan
AU  - Gaurav Deshmukh
AU  - Dhiraj Dhoot
AU  - Rashmi Mamadi
AU  - Hanmant Barkate
Y1  - 2020/11/19
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcd.20200302.13
DO  - 10.11648/j.ijcd.20200302.13
T2  - International Journal of Clinical Dermatology
JF  - International Journal of Clinical Dermatology
JO  - International Journal of Clinical Dermatology
SP  - 28
EP  - 31
PB  - Science Publishing Group
SN  - 2995-1305
UR  - https://doi.org/10.11648/j.ijcd.20200302.13
AB  - Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.
VL  - 3
IS  - 2
ER  -

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Author Information

Harshal Mahajan

Global Medical Affairs (India Formulations), Glenmark Pharmaceuticals ltd, Mumbai, India
Gaurav Deshmukh

Global Medical Affairs (India Formulations), Glenmark Pharmaceuticals ltd, Mumbai, India
Dhiraj Dhoot

Global Medical Affairs (India Formulations), Glenmark Pharmaceuticals ltd, Mumbai, India
Rashmi Mamadi

Global Medical Affairs (India Formulations), Glenmark Pharmaceuticals ltd, Mumbai, India
Hanmant Barkate

Global Medical Affairs (India Formulations, Middle East and Africa, Asia Pacific), Glenmark Pharmaceuticals ltd, Mumbai, India

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APA Style

Harshal Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Rashmi Mamadi, Hanmant Barkate. (2020). Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. International Journal of Clinical Dermatology, 3(2), 28-31. https://doi.org/10.11648/j.ijcd.20200302.13

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ACS Style

Harshal Mahajan; Gaurav Deshmukh; Dhiraj Dhoot; Rashmi Mamadi; Hanmant Barkate. Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. Int. J. Clin. Dermatol. 2020, 3(2), 28-31. doi: 10.11648/j.ijcd.20200302.13

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AMA Style

Harshal Mahajan, Gaurav Deshmukh, Dhiraj Dhoot, Rashmi Mamadi, Hanmant Barkate. Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis. Int J Clin Dermatol. 2020;3(2):28-31. doi: 10.11648/j.ijcd.20200302.13

Copy | Download

@article{10.11648/j.ijcd.20200302.13,
  author = {Harshal Mahajan and Gaurav Deshmukh and Dhiraj Dhoot and Rashmi Mamadi and Hanmant Barkate},
  title = {Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis},
  journal = {International Journal of Clinical Dermatology},
  volume = {3},
  number = {2},
  pages = {28-31},
  doi = {10.11648/j.ijcd.20200302.13},
  url = {https://doi.org/10.11648/j.ijcd.20200302.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20200302.13},
  abstract = {Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis
AU  - Harshal Mahajan
AU  - Gaurav Deshmukh
AU  - Dhiraj Dhoot
AU  - Rashmi Mamadi
AU  - Hanmant Barkate
Y1  - 2020/11/19
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcd.20200302.13
DO  - 10.11648/j.ijcd.20200302.13
T2  - International Journal of Clinical Dermatology
JF  - International Journal of Clinical Dermatology
JO  - International Journal of Clinical Dermatology
SP  - 28
EP  - 31
PB  - Science Publishing Group
SN  - 2995-1305
UR  - https://doi.org/10.11648/j.ijcd.20200302.13
AB  - Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.
VL  - 3
IS  - 2
ER  -

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