Comparison of Calcipotriol Monotherapy and a Combination of Calcipotriol and Methylprednisolone Aceponate Therapy in Psoriasis Patients

ABSTRACT

BACKGROUND: Complete clearance of the lesions by using calcipotriol alone have not been re-ported commonly in the treatment of psoriatic patients. Moreover, lesional and perilesional irritation are reported in some patients using calcipotriol, which may result in premature termination of the treatment due to impairing the compliance. OBJECTIVE: A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol cream and methylprednisolone aceponate was more effective than calcipotriol monotherapy. METHODS: Twenty-one psoriasis patients who had the symmetric lesions on the right and left lower legs were enrolled in the study. A combination of calcipotriol cream and methylprednisolone aceponate therapy was done on the left lower legs, whereas calcipotriol alone was applied on the right lower legs twice daily. PASI score and adverse events were recorded at each visit (1, 2, 3, 4, 6 week). The overall therapeutic result was also assessed by the physician and patients. RESULTS: The initial PASI score was 7.09 on both legs. After 6 weeks, the mean PASI score was 3.85 on the left leg, and 5.70 on the right leg (p<0.05). In the physicianOs global assessment, the percentage of patients who showed the improvement of more than half of lesions was 29% in the monotherapy and 62% in the combination therapy area. Two patients complained of mild itching sense on monotherapy, but there was no specific side effect on combination area. CONCLUSION: The combination therapy was more effective, as assessed by all evaluated variables. Furthermore, this combination reduces the adverse effects caused by long-term use of topical corticosterois as well as the irritation associated with. calcipotriol.