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Topical corticosteroids including clobetasol propionate have been widely used in the treatment of psoriasis since the 1950s. Similar efficacy successes have been reported following 2 weeks of treatment with clobetasol propionate 0.05% (CP) spray or 4 weeks of treatment with calcipotriene 0.005%, betamethasone dipropionate 0.064% (C-BD) ointment in separate studies. Greater efficacy has been noted with clobetasol propionate 0.05% spray when used for 4 weeks compared with 2 weeks with an acceptable safety profile. Clobetasol propionate 0.05% spray and calcipotriene 0.005%, betamethasone dipropionate 0.064% ointment have not previously been directly compared for efficacy and safety in the same study.
It was therefore the aim of this study to compare the efficacy and safety of clobetasol propionate 0.05% spray to calcipotriene 0.005%, betamethasone dipropionate 0.064% ointment in patients with moderate to severe plaque psoriasis for a period of up to 4 weeks. Assessments were made at baseline, Week 2, Week 4 (end of treatment) and Week 8 (4 weeks post treatment).
An assessment for overall disease severity (ODS) found that 75% of CP-spray-treated patients (p =.003) achieved a rating of clear or almost clear after 4 weeks of treatment compared with 45% of C-BD-ointment-treated patients. Adverse events were reported by less than one third of patients from each treatment group (31% for CP spray and 33% for C-BD ointment).
The results of this randomized 4-week comparative study are expected to provide further information to dermatologists considering treatment choices for psoriasis patients who are candidates for topical corticosteroid therapy.
Nurses in the specialized field of dermatology will gain insight into the disease state and treatment options, which will be useful information for patient consultations.
Beutner, K., Chakrabarty, A., Lemke, S., & Yu, K. (2006). An intra-individual randomized safety and efficacy comparison of clobetasol propionate 0.05% spray and its vehicle in the treatment of plaque psoriasis. Journal of Drugs in Dermatology, 5(4), 357-360.
Feldman, S. R., Koo, J. Y., Menter, A., & Bagel, J. (2005). Decision points for the initiation of systemic treatment for psoriasis. Journal of the American Academy of Dermatology, 53(1), 101-107.
Guenther, L., Van de Kerkhof, P. C., Snellman, E., Kragballe, K., Chu, A.C., Tegner, E., et al. (2002). Efficacy and safety of a new combination of calcipotriol and betamethasone dipropionate (once or twice daily) compared to calcipotriol (twice daily) in the treatment of psoriasis vulgaris: A randomized, double-blind, vehicle-controlled clinical trial. British Journal of Dermatology, 147(2), 316-323.
Jarratt, M. T., Clark, S. D., Savin, R. C., Swinyer, L. J., Safley, C. F., Brodell, R. T., et al. (2006). Evaluation of the efficacy and safety of clobetasol propionate spray in the treatment of plaque-type psoriasis. Cutis, 78(5), 348-354.
Kiec-Swierczynska, M., Dudek, B., Krecisz, B., Swierczynska-Machura, D., Dudek, W., Garnczarek, A., et al. (2006). [The role of psychological factors and psychiatric disorders in skin diseases]. Medycyna Pracy, 57(6), 551-555.
Kragballe, K., Austad, J., Barnes, L., Bibby, A., de la Brassinne, M., Cambazard, F., et al. (2006). Efficacy results of a 52-week, randomised, double-blind, safety study of a calcipotriol/betamethasone dipropionate two-compound product (Daivobet/Dovobet/Taclonex) in the treatment of psoriasis vulgaris. Dermatology, 213(4), 319-326.
Kragballe, K., & van de Kerkhof, P. C. (2006). Consistency of data in six Phase III clinical studies of a two-compound product containing calcipotriol and betamethasone dipropionate ointment for the treatment of psoriasis. Journal of the European Academy of Dermatology and Venereology, 20(1), 39-44.
Menter, A., & Griffiths, C. E. (2007). Current and future management of psoriasis. Lancet, 370(9583), 272-284.
van de Kerkhof, P. C. (2003). Psoriasis. St. Louis, MO: Mosby.
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