Combination therapy with tazarotene plus a topical corticosteroid for the treatment of plaque psoriasis

Although tazarotene monotherapy is generally efficacious and well tolerated , studies show that both the efficacy and the tolerability of tazarotene th erapy can be further improved when it is used in combination with certain t opical corticosteroids. The studies reported here evaluate the usefulness o f two potential combination regimens, In one regimen, a corticosteroid is a dded to tazarotene treatment. In the other regimen, corticosteroid treatmen t alternates on a daily basis with tazarotene treatment. The results of the first study, which involved 300 patients, showed that additive combination therapy using tazarotene plus a mid- or high-potency topical corticosteroi d significantly increased the percentage of plaques achieving treatment suc cess at the end of the treatment period, compared with tazarotene plus plac ebo (91% and 95% vs. 80%, respectively; P < 0.05 for both). Similarly, taza rotene plus a mid- or high-potency topical corticosteroid reduced the incid ence of patient withdrawals compared with tazarotene plus placebo (5.5% and 9.6% vs. 13.3%). The results of the second study, which involved 398 patie nts, showed that a combination regimen that alternates between tazarotene a nd a high-potency topical corticosteroid treatment each day, significantly increased the treatment success rate compared with regimens using tazaroten e alternating with a mid-potency corticosteroid or placebo (75% vs. 55% and 54%, respectively at the end of the treatment period; P < 0.05 for both). In addition, there was a trend towards a lower incidence of treatment-relat ed adverse events as corticosteroid potency increased (from 42% with tazaro tene plus placebo to 36%, 32%, and 31% with tazarotene plus the low-, mid-, and high-potency corticosteroid, respectively). Both treatment regimens ar e potentially useful and offer a rational approach to optimizing the effica cy and tolerability of tazarotene treatment for plaque psoriasis.