Calcipotriol and Calcitriol combo with UV phototherapy effective in Chronic Stable Plaque Psoriasis

A recent study published in the journal Photodermatology, Photoimmunology & Photomedicine has demonstrated that the combination therapy of vitamin D derivatives, specifically calcipotriol and calcitriol ointments, along with narrow-band ultraviolet B (NBUVB) phototherapy, is a safe, effective, and well-tolerated option for patients with chronic stable plaque psoriasis. The findings reveal that calcipotriol offers several advantages over calcitriol, including enhanced efficacy, quicker onset of action, and better maintenance of response. Moreover, patients treated with calcipotriol experienced earlier plaque clearance and a lower relapse rate, leading to potential cost savings due to fewer treatment sessions and lower cumulative NB UVB doses.

Plaque psoriasis is a common chronic skin condition characterized by raised, scaly plaques. Vitamin D analogs and NBUVB phototherapy are widely recognized therapeutic approaches for managing this condition.

Led by researchers Disha Chakraborty and Kamal Aggarwal from Pandit BD Sharma University of Health Sciences in Rohtak, India, an open-label intraindividual, left-right study was conducted to compare the efficacy of the two different vitamin D analogs, calcipotriol and calcitriol, in combination with NBUVB phototherapy in patients with chronic stable plaque psoriasis.

● The study enrolled 30 patients with stable plaque psoriasis, consisting of 19 males and 11 females.

● The majority of patients (63.3%) were in the age group of 21-40 years. The average age of the patients was 35.97 ± 10.7 years, indicating that the study primarily focused on adults within a specific age range, which aligns with the typical demographic profile of individuals seeking treatment for chronic plaque psoriasis.

● During the 12-week treatment period, the left side target lesion on each patient's body was treated with calcitriol ointment, while the corresponding lesion on the right side received calcipotriol ointment once daily.

● Patients underwent NBUVB phototherapy three times per week for the entire body. The effectiveness of the treatments was evaluated by assessing target plaque scores.

● Both treatment regimens demonstrated significant reductions in erythema, scaling, thickness, and overall target plaque scores.

● Patients experienced improvements as early as two weeks into the treatment.

● The baseline target plaque score for both groups ranged from 6 to 12, with a mean score of 8.17 ± 1.70.

● Among the patients, the largest proportion (40%) had a body surface area involvement of 11-20%.

● The duration of the disease at the time of inclusion in the study varied from 1 to 20 years, with an average disease duration of less than 5 years.

The combination of calcipotriol and NBUVB phototherapy demonstrated superior results in terms of plaque clearance and relapse rate compared to the combination with calcitriol. The calcipotriol group required fewer treatment sessions and lower cumulative NB UVB doses.

Both treatment regimens demonstrated statistically significant reductions in erythema, scaling, thickness, and overall target plaque scores. Patients showed improvements as early as two weeks into the treatment.While both treatments were effective, the combination of calcipotriol and NBUVB phototherapy exhibited superior results in terms of plaque clearance and relapse rate compared to the calcitriol combination. The calcipotriol group required a lower number of treatment sessions and cumulative NB UVB doses.

The study's findings provide valuable insights into the comparative efficacy of vitamin D analogs in combination with NBUVB phototherapy for chronic stable plaque psoriasis. These results can assist dermatologists in making informed treatment decisions for their patients.

The researchers acknowledged the limitations of their study, including the small sample size and the open-label design, which may introduce biases and restrict the generalizability of the findings. They emphasized the need for larger prospective studies with long-term follow-up to validate and further explore the results.

This study contributes to the growing body of evidence supporting the use of personalized treatment approaches for chronic stable plaque psoriasis, offering hope for improved management and quality of life for patients affected by this challenging condition.

Reference:

Chakraborty D, Aggarwal K. Comparative evaluation of efficacy and safety of calcipotriol versus calcitriol ointment, both in combination with narrow‐band ultraviolet B phototherapy in the treatment of stable plaque psoriasis. Photoderm Photoimm Photomed. 2023.