Efficacy and tolerance of topical calcitriol 3 mu g g(-1) in psoriasis treatment: a review of our experience in Poland

Although topical vitamin D-3 derivatives have been used in the treatment of patients with psoriasis for the past 15 years, questions remain about the indications and limitations of application. Extensive personal experience g ained during the development of calcitriol (1 alpha 25-dihydroxyvitamin D-3 ) is therefore reviewed. Three double-blind, vehicle-controlled trials have revealed that calcitriol 3 mug g(-1) ointment (Silkis ointment(R), Galderm a Laboratories) has very good clinical efficacy. In a left-right comparison with vehicle ointment, complete clearance of psoriatic lesions was achieve d in 48% of sites treated with calcitriol and a further 41% showed consider able or definite improvement. The clinical response to calcitriol in anothe r study was as good as, or even better than, that achieved with betamethaso ne valerate 0.1% ointment. A preparation containing calcitriol 15 mug g(-1) did not show any clinical superiority to the lower dose but was associated with a higher risk of hypercalciuria, particularly when applied to extensi ve skin lesions. These results suggest that calcitriol 3 mug g(-1) ointment is an effective and safe treatment for chronic plaque psoriasis.