CLOBETASOL PROPIONATE FOLLOWED BY CALCIPOTRIOL IS SUPERIOR TO CALCIPOTRIOL ALONE IN TOPICAL TREATMENT OF PSORIASIS

Background Although potent, topical corticosteroids offer effective an d rapid healing of psoriatic lesions. Their long term use is limited b ecause of the risk of side effects. Calcipotriol is safe for long-term treatment, but its initial efficacy is lower than with topical cortic osteroids. Objectives To investigate whether 2 weeks of treatment with clobetasol propionate 0.05% ointment bd followed by 4 weeks of treatm ent with calcipotriol 50 mu g/g bd would offer therapeutic advantages over 6 weeks of continuous treatment with calcipotriol. Methods Forty- nine patients with moderate to severe prague psoriasis were recruited from five centres in Norway. In a randomised, double-blind, right- ver sus left-side comparison, ointments were applied to two symmetrically- located areas. Results Two weeks of treatment with clobetasol propiona te produced a significantly greater decrease in total symptom score (c ombined scores of erythema, induration and scaling) than calcipotriol treatment (P < 0.0001). This improvement on the clobetasol propionate- treated side of the body was maintained throughout a subsequent 4-week treatment period when calcipotriol was applied to both sides of the b ody (P < 0.0001). The superiority of the clobetasol propionate followe d by calcipotriol treatment was maintained during a 4-week, treatment- free, observation period. Treatments were well tolerated with no rebou nd effect. Conclusions Clobetasol propionate ointment bd for 2 weeks f ollowed by treatment with calcipotriol ointment bd for 4 weeks was sup erior to calcipotriol ointment alone in the treatment of plague psoria sis. (C) 1998 Elsevier Science B.V. All rights reserved.