A comparative study of efficacy and safety of topical calcitriol and topical calcipotriol in stable chronic plaque type psoriasis

Authors

  • Leela Hugar Department of Pharmacology, BM Patil Medical College, Vijayapura, Karnataka, India
  • Ramesh H. Department of Pharmacology, Karnataka Institute of Medical Science, Hubli, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20190509

Keywords:

Calcipotriol, Calcitriol, Cutaneous safety, Cutaneous discomfort, Global assessment, Plaque type psoriasis

Abstract

Background: Topical calcitriol and calcipotriol, the two vitamin D derivatives although considered efficient in treating psoriasis, their comparative studies are relatively scanty. The objective of the present study was to evaluate and compare the efficacy and safety of calcitriol and calcipotriol in stable chronic plaque-type psoriasis.

Methods: Total 50 patients of chronic stable plaque-type psoriasis were randomly divided into two groups of 25 each. One group received calcitriol 3µg/g ointment and the other group received calcipotriol 50µg/g ointment twice daily for 12 weeks. Efficacy evaluations comprised global improvement (on a 4-point scale from 0: no change, to 3: clear or almost clear) assessed clinically and by the subject. Efficacy further included the ‘dermatological sum score’ (DSS) at each study visit. Safety evaluations (on a 5-point scale from 0: none, to 4: very severe) included clinical assessment of cutaneous safety and assessment of cutaneous discomfort by the subject.

Results: Both calcitriol and calcipotriol were significantly effective (p <0.001) in reduction of DSS but the difference between the two groups was not statistically significant. Mean score of global improvement assessed clinically was 2.20 for calcitriol and 2.16 for calcipotriol (p >0.05) and by the subject was 1.92 for calcitriol and 1.84 for calcipotriol (p >0.05). The difference between the two groups was not statistically significant. The mean worst score for cutaneous safety was higher in calcipotriol group compared to calcitriol group (0.28 vs 0.04 and 0.36 vs 0.04 by clinically and by the subject, respectively). Statistically significant better safety profile (p <0.05) was seen for calcitriol, only when assessed by the subject. 24% treatment related adverse events were reported with calcipotriol against only 4% with calcitriol.

Conclusions: Topical calcitriol and calcipotriol showed similar efficacy in the treatment of chronic plaque psoriasis while calcitriol showed better safety profile in comparison with calcipotriol, in terms of local tolerance and induced less treatment related adverse events.

References

Griffiths CEM, Barker JNWN. Psoriasis. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s textbook of Dermatology. vol 1. 8th ed. UK: Wiley-Blackwell; 2010. p. 20.1-20.60.

Dogra S, Yadav S. Psoriasis in India: Prevalance and pattern. Indian J Dermatol Venereol Leprol. 2010; 76(6):595-01.

Gudjonsson JE, Elder JT. Psoriasis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8th ed. USA: McGraw Hill; 2012:197-231.

Richardson SK, Gelfand JM. Update on the natural history and systemic treatment of psoriasis. Advances Dermatol. 2008;24:171.

Hussain I, Haroon TS. Comorbidities in psoriasis and their therapeutic implications. J Pakistan Assoc Dermatol. 2016 Dec 24;19(2):63-5.

Singh G, Aneja SP. Cardiovascular comorbiditiy in psoriasis. Indian J Dermatol. 2011 Sep;56(5):553-6.

Blauvelt A. New concepts in the pathogenesis and treatment of psoriasis: key roles for IL-23, IL-17A and TGF-β1. Expert Rev Dermatol. 2007 Feb 1;2(1):69-78.

Aschoff R, Wozel G, Meurer M. Topical treatment of psoriasis: a systematic update. Dermatol J Dermatol Venereol Related Fields. 2003 Mar;54(3):237-41.

Sweetman SC, editor. Martindale: The complete drug reference. 37th edition. London: Pharmaceutical press; 2011:1716-64.

Zhu X, Wang B, Zhao G, Gu J, Chen Z, Briantais P, Andres P. An investigator‐masked comparison of the efficacy and safety of twice daily applications of calcitriol 3µg/g ointment vs. calcipotriol 50 µg/g ointment in subjects with mild to moderate chronic plaque‐type psoriasis. J Eur Acad Dermatol Venereol. 2007 Apr;21(4):466-72.

Langner A, Stapor W, Ambroziak M. Efficacy and tolerance of topical calcitriol 3μg/g in psoriasis treatment: a review of our experience in Poland. Br J Dermatol. 2001;144(suppl.58):11-16.

Lebwohl M, Menter A, Weiss J, Clark SD, Flores J, Powers J, et al. Calcitriol 3 microg/g ointment in the management of mild to moderate plaque type psoriasis: results from 2 placebo-controlled, multicenter, randomized double-blind, clinical studies. J Drugs Dermatol. 2007 Apr;6(4):428-35.

Ashcroft DM, Po AL, Williams HC, Griffiths CE. Systematic review of comparative efficacy and tolerability of calcipotriol in treating chronic plaque psoriasis. BMJ. 2000 Apr 8;320(7240):963-7.

Scott LJ, Dunn CJ, Goa KL. Calcipotriol ointment. A review of its use in the management of psoriasis. Am J Clin Dermatol. 2001;2(2):95-120.

Ortonne JP, Humbert P, Nicolas JF, Tsankov N, Tonev SD, Janin A, et al. Intra‐individual comparison of the cutaneous safety and efficacy of calcitriol 3 µg g− 1 ointment and calcipotriol 50µg g−1 ointment on chronic plaque psoriasis localized in facial, hairline, retroauricular or flexural areas. Br J Dermatol. 2003 Feb;148(2):326-33.

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Published

2019-02-23

How to Cite

Hugar, L., & H., R. (2019). A comparative study of efficacy and safety of topical calcitriol and topical calcipotriol in stable chronic plaque type psoriasis. International Journal of Basic & Clinical Pharmacology, 8(3), 402–408. https://doi.org/10.18203/2319-2003.ijbcp20190509

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Original Research Articles