COMPARATIVE EFFECTS OF CALCIPOTRIOL SOLUTION (50-MU-G ML) AND BETAMETHASONE 17-VALERATE SOLUTION (1-MG/ML) IN THE TREATMENT OF SCALP PSORIASIS/

The efficacy, tolerability and safety of calcipotriol solution and bet amethasone 17-valerate solution were compared in a multicentre, prospe ctive, randomized, double-blind, parallel group study. Four hundred an d seventy-four patients with scalp psoriasis were recruited from six E uropean countries and Canada. Following a 2-week washout period, eithe r calcipotriol solution (50 mu g/ml) or betamethasone 17-valerate solu tion (1 mg/ml) was applied twice daily for 4 weeks. After this time, p atients who required no further active treatment were observed for rel apse. Retreatment with calcipotriol was offered to those patients who relapsed, and who were originally in the calcipotriol-treated group. T he two treatment groups were well matched at baseline. At the end of t reatment, the proportion of patients who had 'cleared' or 'markedly im proved' was statistically significantly greater in the betamethasone g roup (75%) than in the calcipotriol group (58%) (P < 0.001) (95% confi dence interval of difference 25.3 --> 8.6). The decrease in total sign score (sum of scores for erythema, thickness and scaliness) at the en d of treatment was also statistically significantly greater in the bet amethasone group (61%) than the calcipotriol group (45%) (P < 0.001) ( 95% confidence interval of difference 9.7 --> 23.1). Adverse events we re reported by 87 patients in the calcipotriol group, and 31 patients in the betamethasone group; the most common was lesional or perilesion al irritation, which occurred significantly more frequently with calci potriol (26%) than with betamethasone (8%) (P < 0.001). Fifteen patien ts (6%) in the calcipotriol group and four (1%) in the betamethasone g roup withdrew from the study because of adverse events or unacceptable treatment response (P = 0.017). There was no statistically significan t change in serum total calcium in either treatment group. There was n o significant difference in the rate of relapse between the two treatm ent groups. In the 69 calcipotriol-treated patients who relapsed, re-t reatment with calcipotriol was effective and well tolerated. Calcipotr iol solution was effective in treating mild to moderate scalp psoriasi s. However, betamethasone solution was significantly more effective, a nd was associated with statistically significantly less local irritati on on the scalp and face.