Calcipotriene in Topical Treatment of Psoriasis
The Uses of Vitamin D3 Analogues in Psoriasis
Jan 3, 2009
Calcipotriene is not as effective as super potent topical corticosteroids, but regimens in which patients apply both calcipotriene and super potent corticosteroids have demonstrated superiority over either agent alone.
Which Types of Psoriasis are Treated With Calcipotriene?
Plaque psoriasis responds well to calcipotriene. Calcipotriene solution is useful in scalp psoriasis and nail psoriasis.
How Effective is Calcipotriene in Psoriasis?
In clinical trials the effectiveness of calcipotriene in psoriasis was shown to be comparable to or slightly better than class II corticosteroid ointments such as fluocinonide 0.05% used as one of the topical therapies for psoriasis . In trials in which calcipotriene was compared with anthralin, it fared well in terms of clinical efficacy and was preferred by patients because it does not stain as much as anthralin and is less irritating. Hence it is preferred over anthralin in topical treatment of psoriasis .
Calcipotriene ointment has been shown to enhance the efficacy of PUVA and UVB phototherapy in psoriasis. Calcipotriene used in combination or as a sequential therapy with potent steroids increases the effectiveness of both agents.
How Does Calcipotriene Work in Psoriasis?
The mechanism of action of calcipotriene is via vitamin D receptor mediated effects on the proliferation and differentiation of the keratinocytes, the epidermal cells of the skin. Studies have also shown action on the immunological features of psoriasis.
Is Calcipotriene Safe For Use in Children?
Calcipotriene, in the concentration of 50microgram/gm ointment, has been shown to be effective and safe for use in children when administered up to 45 g per week per square meter of body area.
What is Sequential Therapy in Psoriasis?
Calcipotriene is not as effective as super potent topical corticosteroids, but regimens in which patients apply both calcipotriene and super potent corticosteroids have demonstrated superiority over either agent alone.
A combination or sequential regimen in which calcipotriene ointment was applied in the morning and halobetasol ointment applied in the evening for 2 weeks. That regimen proved to be superior to monotherapy with halobetasol ointment twice daily or calcipotriene ointment twice daily for 2 weeks. A ‘weekdays’ calcipotriene and ‘weekends’ steroid sequential therapy is also very popular due to its high efficacy and low side effect profile.
Side Effects of Calcipotriene
- Local irritation is the most frequent side effect of calcipotriene, affecting 20% of treated patients.
- Vitamin D and its analogues have the potential to disturb the calcium metabolism and cause elevation of calcium in the blood and urine. Hence it is advised that the dosage of 50 gm per m2 of body area of calcipotriene should not be exceeded in adults.
Next: Does Stress Cause Psoriasis?
Further Reading
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
