COMPARATIVE-STUDY OF CALCIPOTRIENE (MC-903) OINTMENT AND FLUOCINONIDEOINTMENT IN THE TREATMENT OF PSORIASIS

Background: The topical vitamin D analogue calcipotriene has been repo rted to be an effective treatment for patients with psoriasis. Compara tive studies with topical steroids are informative in judging this new therapy. Objective: The purpose of this study was to evaluate the eff icacy and safety of calcipotriene ointment 0.005% versus fluocinonide ointment 0.05% in the treatment of plaque psoriasis. Methods: This stu dy was a randomized, double-blind, parallel-group, active-controlled t rial in adults who had at least mild overall disease severity and plaq ue elevation of at least moderate severity. Treatments were applied tw ice daily for 6 weeks, and subjects were evaluated at weeks 0, 2, 4, a nd 6. Subjects were graded on a 9-point scale (0 to 8) for scaling, er ythema, plaque elevation, and for overall disease severity. A physicia n's global assessment of improvement/worsening was performed at every visit. Results: A total of 114 subjects were enrolled at six study sit es. Ninety-nine subjects completed the trial. Mean scores for signs of scaling and plaque elevation in calcipotriene-treated subjects were s ignificantly lower by week 2 than in the fluocinonide-treated subjects . These scores continued to be significantly lower than fluocinonide t hrough week 6 (p < 0.05). Mean scores for erythema in calcipotriene-tr eated subjects were significantly lower than those in fluocinonide-tre ated subjects at weeks 4 and 6 (p < 0.05). Both the physician's global assessment and overall disease severity showed statistically signific ant treatment differences in favor of calcipotriene at week 4 (p < 0.0 5). This superior efficacy continued through week 6. Treatment-related adverse events were observed in 12 calcipotriene-treated subjects and 5 fluocinonide-treated subjects; all were considered minor. Conclusio n: Calcipotriene was superior to fluocinonide in the treatment of plaq ue psoriasis.