Calcipotriol cream combined with twice weekly broad-band UVB phototherapy:A safe, effective and UVB-sparing antipsoriatric combination treatment

Background: Calcipotriol has been combined with a number of systemic antips oriatric treatments, improving efficacy or reducing the systemic treatment required. Although studies on calcipotriol and UVB have also been performed , there are no data on the UVB-saving effect of calcipotriol combined with broad-band UVB to reduce overall UVB exposure, while maintaining efficacy. Objectives: To assess the efficacy and safety of calcipotriol cream (50 mu g/g) combined with twice weekly broad-band UVB and to determine if this tre atment would require fewer UVB treatments and lower cumulative UVB irradian ce when compared to a standard 3 times weekly broad-band UVB regime in pati ents with extensive psoriasis. Methods: This multicentre, prospective, rand omised, parallel-group, vehicle-controlled, single-blind (investigator) stu dy consisted of a 1-week wash-out phase, 12-week treatment phase and 12-wee k follow-up phase. Broad-band UVB equipment was standardised and calibrated prior to the study. The UVB starting dose was based on the patient's minim al erythema dose. Assessments included PASI, extent, severity and investiga tor and patient's overall assessments of the psoriasis. Results: Fewer expo sures (12 vs. 19) and less cumulative UVB irradiance (1,570 vs. 5,430 mJ/cm (2)) were required by the calcipotriol + twice weekly UVB group to achieve 80% reduction in PASI (p < 0.001). Similarly, fewer exposures (22 vs. 25) a nd less cumulative UVB irradiance (4,147 vs. 9,670 mJ/cm(2)) were required by this group to achieve total clearance (p < 0.001). There was no differen ce in the PASI, patient's and investigator's overall assessments and number of adverse events recorded by either group for both the treatment and foll ow-up phases. Conclusion: Calcipotriol cream + twice weekly broad-band UVB phototherapy is an effective and safe antipsoriatric treatment, resulting i n fewer UVB exposures, lower cumulative irradiance and a saving of time. Co pyright (R) 2000 S. Karger AG. Basel.