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Sreya R, Nene S, Pathade V, Singh SB, Srivastava S. Emerging trends in combination strategies with phototherapy in advanced psoriasis management. Inflammopharmacology 2023:10.1007/s10787-023-01257-2. [PMID: 37326755 DOI: 10.1007/s10787-023-01257-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023]
Abstract
Psoriasis is a non-contagious, chronic, relapsing inflammatory skin disease with cutaneous manifestations such as red, raised scaly plaques. Current treatment approaches for psoriasis comprise topical therapy, systemic therapy, phototherapy, psoralen with UVA(PUVA) and biologics. Regardless of the progression in therapeutic approaches (novel therapies like biologics) in psoriasis, phototherapy is also an economical, compelling and safe treatment option that lacks the immunosuppressive properties as well as the toxicities of traditional modalities. It can be combined safely with other therapeutic options such as topical therapies and novel biologics and provide effective therapy. The aim of the current review is to analyze the literature on the safety as well as the efficacy of phototherapy with various treatment modalities in the management of psoriasis. This review summarizes randomized controlled clinical trials addressing combinations of phototherapy with other treatment modalities for the management of psoriasis. The findings of these clinical studies are elaborated.
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Affiliation(s)
- Ratnam Sreya
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, Telangana, 500037, India
| | - Shweta Nene
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, Telangana, 500037, India
| | - Vrushali Pathade
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, Telangana, 500037, India
| | - Shashi Bala Singh
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, India
| | - Saurabh Srivastava
- Pharmaceutical Innovation and Translational Research Lab (PITRL), Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad, Telangana, 500037, India.
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2
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Teixeira A, Teixeira M, Almeida V, Gaio R, Torres T, Magina S, Cunha C, Sousa Lobo JM, Almeida IF. Does the Vehicle Matter? Real-World Evidence on Adherence to Topical Treatment in Psoriasis. Pharmaceutics 2021; 13:1539. [PMID: 34683831 PMCID: PMC8539972 DOI: 10.3390/pharmaceutics13101539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 01/13/2023] Open
Abstract
The influence of the vehicle in topical treatment adherence remains to be elucidated. The aim of this study is to analyze the influence of the pharmaceutical dosage form on adherence to topical treatment in psoriasis patients, taking into consideration the mechanical features. The adherence was evaluated in a sample of 102 psoriasis patients, followed for approximately 45 days. Adherence was calculated with a new combined methodology using a log and medication weights. The effect of the group formulation was evaluated using logistic regression models. A complex effect of the vehicle on adherence was found, mediated by the affected area. The adherence was significantly higher for patients applying gels and creams than for those using ointments, whenever the body area affected was extensive. The opposite was found when the affected area was small. Mechanical properties can partially explain the findings since gels and creams may be easier to apply. Patient beliefs and preferences regarding vehicles and their sensory attributes might also explain the results. It is noteworthy that adherence was strikingly low, with more than 75% non-adherent patients. This real-world evidence provides an insight for pharmaceutical industries and guidance for treatment prescription by physicians aiming to address the public health emergency of treatment non-adherence.
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Affiliation(s)
- Ana Teixeira
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal; (A.T.); (V.A.)
- Laboratório de Tecnologia Farmacêutica, MedTech, UCIBIO-REQUIMTE, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal;
| | - Maribel Teixeira
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal; (A.T.); (V.A.)
| | - Vera Almeida
- Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Instituto Universitário de Ciências da Saúde, CESPU, 4585-116 Gandra, Portugal; (A.T.); (V.A.)
| | - Rita Gaio
- Centro de Matemática, Departamento de Matemática, Faculdade de Ciências, Universidade do Porto, 4169-007 Porto, Portugal;
| | - Tiago Torres
- Serviço de Dermatologia, Centro Hospitalar do Porto, Hospital de Santo António, 4099-001 Porto, Portugal;
| | - Sofia Magina
- Serviço de Dermatologia, Centro Hospitalar de São João, Departamento de Farmacologia e Terapêutica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal;
| | - Cátia Cunha
- Serviços Farmacêuticos, Centro Hospitalar do Tâmega e Sousa, 4564-007 Penafiel, Portugal;
| | - José M. Sousa Lobo
- Laboratório de Tecnologia Farmacêutica, MedTech, UCIBIO-REQUIMTE, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal;
| | - Isabel F. Almeida
- Laboratório de Tecnologia Farmacêutica, MedTech, UCIBIO-REQUIMTE, Departamento de Ciências do Medicamento, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal;
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3
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Guo JW, Jee SH. Strategies to Develop a Suitable Formulation for Inflammatory Skin Disease Treatment. Int J Mol Sci 2021; 22:ijms22116078. [PMID: 34199951 PMCID: PMC8200229 DOI: 10.3390/ijms22116078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 12/16/2022] Open
Abstract
Skin barrier functions, environmental insults, and genetic backgrounds are intricately linked and form the basis of common inflammatory skin disorders, such as atopic dermatitis, psoriasis, and seborrheic dermatitis, which may seriously affect one’s quality of life. Topical therapy is usually the first line of management. It is believed that successful topical treatment requires pharmaceutical formulation from a sufficient dosage to exert therapeutic effects by penetrating the stratum corneum and then diffusing to the target area. However, many factors can affect this process including the physicochemical properties of the active compound, the composition of the formulation base, and the limitations and conditions of the skin barrier, especially in inflammatory skin. This article briefly reviews the available data on these issues and provides opinions on strategies to develop a suitable formulation for inflammatory skin disease treatment.
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Affiliation(s)
- Jiun-Wen Guo
- Department of Medical Research, Cathay General Hospital, Taipei 10630, Taiwan
- Program in Pharmaceutical Biotechnology, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Correspondence: ; Tel.: +886-2864-61500 (ext. 2327)
| | - Shiou-Hwa Jee
- Department of Dermatology, Cathay General Hospital, Taipei 10630, Taiwan;
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
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Hosseinzadeh L, Nemati H, Nemati N, Sadeghi M. Spherical Gold Nanoparticles: Small Interfering RNA Delivery in Regulation of the Tumor Necrosis Factor-Alpha Gene Expression. J Interferon Cytokine Res 2020; 40:490-496. [PMID: 32865449 DOI: 10.1089/jir.2020.0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Proinflammatory cytokines are signaling molecules that are expelled from immune cells like macrophages and other types of cells. Tumor necrosis factor-alpha (TNF-α) is overexpressed during inflammation caused by inflammatory diseases. Therefore, the regulation of TNF-α has a key role in inflammation. The use and target delivery of small interfering RNAs (siRNAs) provide many effectual treatment benefits in the regulation of gene expression in cells. In this study, we used siRNA nanoparticle conjugates in the regulation of gene expression and inflammation. We first prepared safe fusion ribonucleic acid interference carrier, spherical nucleic acid nanoparticle conjugates (SNA-NCs), to enhance the perforation of siRNA into the macrophages and their ability to target TNF-α gene regulation. Furthermore, the suppression of the TNF-α gene was monitored after curing macrophages by SNA-NCs. Gene expression was carried out by real-time polymerase chain reaction in cells and the levels of TNF-α were investigated by the enzyme-linked immunosorbent assay (ELISA) method. This study indicated that the SNA-NCs were safe and very stable. TNF-α siRNA could significantly regulate gene expression in cells to form SNA-NCs. The results indicated that TNF-α gene expression downregulated to 93.40% ± 1.45%, 66.06% ± 0.95%, and 35.76% ± 1.09% in the presence of 0.1, 1, and 10 nM siRNA, respectively. The proliferation of macrophages and subsequently expression of TNF-α were significant for the formation of inflammation. These findings showed that the use of SNA-NC siRNA might ameliorate the inflammatory disease by suppression of gene expression and functional activity of macrophage generation.
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Affiliation(s)
- Leila Hosseinzadeh
- Pharmaceutical Sciences Research Center, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Houshang Nemati
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Nemati
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Saka R, Jain H, Kommineni N, Chella N, Khan W. Enhanced penetration and improved therapeutic efficacy of bexarotene via topical liposomal gel in imiquimod induced psoriatic plaque model in BALB/c mice. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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6
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Kalashnikova NG, Lotti T, Urakova DS, Jafferany M. Treatment of psoriatic skin lesions with a new Er:Yag laser technology: A case series study. Dermatol Ther 2020; 33:e13264. [DOI: 10.1111/dth.13264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/02/2020] [Accepted: 02/07/2020] [Indexed: 12/28/2022]
Affiliation(s)
| | - Torello Lotti
- Dermatology and Venereology Guglielmo Marconi University Rome Italy
| | - Diana S. Urakova
- Department of Dermatology Institute of Medical and Social Technologies Moscow Russia
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Vasconcelos V, Teixeira A, Almeida V, Teixeira M, Ramos S, Torres T, Sousa Lobo JM, Almeida IF. Patient preferences for attributes of topical anti-psoriatic medicines. J DERMATOL TREAT 2018; 30:659-663. [PMID: 30470146 DOI: 10.1080/09546634.2018.1544410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Patient preferences should be considered when prescribing topical treatments to drive up adherence and improve clinical outcomes. Objective: The aim of this work was to identify the most important attributes of topical medicines for psoriasis treatment in the patients' view, and explore the sociodemographic and clinical determinants of these preferences. Methods: A questionnaire for the evaluation of the relevancy given to specific attributes of topical medicines used for psoriasis treatment was developed (PSO-TOPAP) and was applied to a total of seventy-nine patients, members of the Portuguese Association of Psoriasis (PSOPortugal) or outpatients of a dermatology unit of a central hospital. Results: Overall, attributes belonging to the formulation and application domains were greatly valued over attributes related to the container. Only a small number of patient preferences was influenced by age, gender, duration of the disease and age at first diagnosis. Limitations: Our findings need to be verified in larger and more diverse patient samples before generalization can be made. Conclusion: The insight obtained in this work can provide guidance to pharmaceutical drug product design and has also the potential to improve patient care through the acknowledgment of patient preferences in clinical practice.
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Affiliation(s)
- V Vasconcelos
- a CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra PRD , Portugal
| | - A Teixeira
- a CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra PRD , Portugal.,b UCIBIO- REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy University of Porto , Porto , Portugal
| | - V Almeida
- a CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra PRD , Portugal.,b UCIBIO- REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy University of Porto , Porto , Portugal
| | - M Teixeira
- a CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde , Gandra PRD , Portugal
| | - S Ramos
- c ISEP, Instituto Superior de Engenharia do Porto, Politécnico do Porto , Porto , Portugal.,d CEAUL, Centro de Estatística e Aplicações da Universidade de Lisboa, Faculdade de Ciências , Campo Grande , Portugal
| | - T Torres
- e Serviço de Dermatologia, Centro Hospitalar do Porto, Hospital de Santo António , Porto , Portugal
| | - J M Sousa Lobo
- b UCIBIO- REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy University of Porto , Porto , Portugal
| | - I F Almeida
- b UCIBIO- REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy University of Porto , Porto , Portugal
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Vender R, Gooderham MJ, Guenther LC, Kyritsis D, Rao J, Kowalczyk A, Ashkenas J. Canadian Patients' Preferences in Topical Psoriasis Care: Insights From the PROPEL Surveys. J Cutan Med Surg 2018; 22:464-471. [PMID: 29754528 DOI: 10.1177/1203475418773736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patients with psoriasis of all severities employ topical treatment, either alone or in combination. Promoting Patient Engagement at the Leading Edge of Topical Psoriasis Treatment (PROPEL) surveyed Canadian dermatologists and their patients about their attitudes toward topical care. OBJECTIVES To identify gaps between patients and dermatologists regarding the burden of psoriasis, the burden of treatment, and priorities for topical care to Canadian patients with psoriasis. METHODS Two parallel surveys explored patient attitudes toward psoriasis and their experience with topical care, as expressed by patients or as perceived by their dermatologists. A third survey, addressed to patients, included additional questions regarding treatment adherence to current topical treatment regimens. RESULTS PROPEL dermatologists underestimated the burden associated with psoriatic itch. Otherwise, they were well aligned with patients' views, including their preference for maintaining topical care of their psoriasis over other treatment modalities, the nature of good psoriasis control, and desirable features of topical medications. Despite holding generally positive views of topical therapy, many patients self-identified as poorly adherent. CONCLUSIONS Long-term adherence to psoriasis topical care remains a challenge. Formulations with improved acceptability might help patients maintain good adherence.
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Affiliation(s)
- Ronald Vender
- 1 Dermatrials Research, Inc, Hamilton, ON, Canada.,2 Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | - Melinda J Gooderham
- 3 SKiN Centre for Dermatology, Peterborough, ON, Canada.,4 Queens University, Kingston, ON, Canada
| | - Lyn C Guenther
- 5 Guenther Dermatology Research Centre, London, ON, Canada.,6 Western University, London, ON, Canada
| | | | - Jaggi Rao
- 8 Division of Dermatology, University of Alberta, Edmonton, AB, Canada
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Nemati H, Ghahramani MH, Faridi-Majidi R, Izadi B, Bahrami G, Madani SH, Tavoosidana G. Using siRNA-based spherical nucleic acid nanoparticle conjugates for gene regulation in psoriasis. J Control Release 2017; 268:259-268. [DOI: 10.1016/j.jconrel.2017.10.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/19/2017] [Accepted: 10/21/2017] [Indexed: 12/14/2022]
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10
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Chiricozzi A, Pimpinelli N, Ricceri F, Bagnoni G, Bartoli L, Bellini M, Brandini L, Caproni M, Castelli A, Fimiani M, Marsili F, Mazzatenta C, Niccoli MC, Panduri S, Pellegrino M, Sirna R, Volpi W, Romanelli M, Prignano F. Treatment of psoriasis with topical agents: Recommendations from a Tuscany Consensus. Dermatol Ther 2017; 30. [PMID: 28940579 DOI: 10.1111/dth.12549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/06/2017] [Accepted: 07/28/2017] [Indexed: 11/30/2022]
Abstract
Psoriasis is a chronic and relapsing inflammatory skin disease, clinically characterized by erythematous and scaly plaques. Treatment approach is mainly driven by disease severity, though several factors should be considered in order to identify the optimal therapeutic choice. Mild psoriasis may be treated with a wide array of topical agents including corticosteroids, vitamin D analogs, keratolytics, and calcipotriol/betamethasone propionate compound. Because guidelines may not provide practical indications regarding the therapeutic approach, the use of topical agents in psoriasis is more individually tailored. In order to homogenize the standard of care, at least in a local setting, we collected the real-life-based recommendations for the use of topical therapies from an expert panel, the Tuscany Consensus Group on Psoriasis, representing all leading centers for psoriasis established in Tuscany. With this document, this consensus group sought to define principles guiding the selection of therapeutic agents with straightforward recommendations derived from a real-life setting.
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Affiliation(s)
- Andrea Chiricozzi
- Dermatology Department, University of Pisa. Via Roma 67, 56126 Pisa, Italy
| | - Nicola Pimpinelli
- Department of Surgery and Translational Medicine, Section of Dermatology and Venereology, University of Florence School of Medicine, Florence, Italy
| | - Federica Ricceri
- Department of Surgery and Translational Medicine, Section of Dermatology and Venereology, University of Florence School of Medicine, Florence, Italy
| | | | - Laura Bartoli
- Dermatology Unit, San Jacopo Hospital, ASL 3, Pistoia, Italy
| | - Mauro Bellini
- Dermatology Unit, Carrara Hospital, USL nordovest, Carrara, Italy
| | - Luca Brandini
- Dermatology Unit, San Giuseppe Hospital, ASL 11, Empoli, Italy
| | - Marzia Caproni
- Dermatologic Rare Diseases and Skin Immunopathology Unit, University of Florence, Florence, Italy.,U.O. Dermatology I, University of Florence, Florence, Italy
| | | | - Michele Fimiani
- Departmernt of Dermatology, Division of Medical, Surgical and Neurosciences, University of Siena, Siena Italy
| | - Franco Marsili
- Dermatology Unit, Versilia Hospital, ASL 12, Lido di Camaiore, Lucca, Italy
| | | | | | - Salvatore Panduri
- Dermatology Department, University of Pisa. Via Roma 67, 56126 Pisa, Italy
| | - Michele Pellegrino
- Departmernt of Dermatology, Division of Medical, Surgical and Neurosciences, University of Siena, Siena Italy
| | - Riccardo Sirna
- Dermatology Unit, Misericordia Hospital, ASL 9, Grosseto, Italy
| | - Walter Volpi
- U.O. Dermatology I, University of Florence, Florence, Italy
| | - Marco Romanelli
- Dermatology Department, University of Pisa. Via Roma 67, 56126 Pisa, Italy
| | - Francesca Prignano
- Department of Surgery and Translational Medicine, Section of Dermatology and Venereology, University of Florence School of Medicine, Florence, Italy
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Mijušković ŽP, Kandolf-Sekulović L, Tiodorović D, Nikolić M, Jovanović M, Škiljević D, Gajinov Z, Zečević RD. Serbian Association of Dermatovenereologists’ Guidelines for the Diagnosis and Treatment of Psoriasis. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2017. [DOI: 10.1515/sjdv-2016-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Željko P. Mijušković
- Clinic of Dermatovenereology, School of Medicine, Military Medical Academy, Belgrade, Republic of Serbia
| | - Lidija Kandolf-Sekulović
- Clinic of Dermatovenereology, School of Medicine, Military Medical Academy, Belgrade, Republic of Serbia
| | - Danica Tiodorović
- Clinic of Dermatovenereology, Clinical Center of Niš, Faculty of Medicine, University of Niš, Republic of Serbia
| | - Miloš Nikolić
- Clinic of Dermatovenereology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Republic of Serbia
| | - Marina Jovanović
- Clinic of Dermatovenereology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Republic of Serbia
| | - Dušan Škiljević
- Clinic of Dermatovenereology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Republic of Serbia
| | - Zorica Gajinov
- Clinic of Dermatovenereology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Republic of Serbia
| | - Radoš D. Zečević
- Clinic of Dermatovenereology, School of Medicine, Military Medical Academy, Belgrade, Republic of Serbia
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Koo J, Tyring S, Werschler WP, Bruce S, Olesen M, Villumsen J, Bagel J. Superior efficacy of calcipotriene and betamethasone dipropionate aerosol foam versus ointment in patients with psoriasis vulgaris--A randomized phase II study. J DERMATOL TREAT 2015; 27:120-7. [PMID: 26444907 PMCID: PMC4772687 DOI: 10.3109/09546634.2015.1083935] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: An aerosol foam formulation of fixed combination calcipotriene 0.005% (as hydrate; Cal) plus betamethasone dipropionate 0.064% (BD) was developed to improve psoriasis treatment. Objectives: To compare the efficacy and safety of Cal/BD aerosol foam with Cal/BD ointment after 4 weeks. Methods: In this Phase II, multicenter, investigator-blind, 4-week trial, adult patients with psoriasis vulgaris were randomized to Cal/BD aerosol foam, Cal/BD ointment, aerosol foam vehicle or ointment vehicle (3:3:1:1). The primary efficacy endpoint was the proportion of patients at week 4 who achieved treatment success (clear or almost clear with at least a two-step improvement) according to the physician’s global assessment of disease severity. Results: In total, 376 patients were randomized. At week 4, significantly more patients using Cal/BD aerosol foam achieved treatment success (54.6% versus 43.0% [ointment]; p = 0.025); mean modified (excluding the head, which was not treated) psoriasis area and severity index score was significantly different between Cal/BD aerosol foam and Cal/BD ointment (mean difference –0.6; p = 0.005). Rapid, continuous itch relief occurred with both active treatments. One adverse drug reaction was reported with Cal/BD aerosol foam (application site itch). Conclusions: Cal/BD aerosol foam demonstrates significantly greater efficacy and similar tolerability compared with Cal/BD ointment for psoriasis treatment.
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Affiliation(s)
- John Koo
- a Department of Dermatology , University of California , San Francisco , San Francisco , CA , USA
| | - Stephen Tyring
- b Department of Dermatology , University of Texas Health Science Center , Houston , TX , USA
| | | | - Suzanne Bruce
- d Suzanne Bruce and Associates, PA , Houston , TX , USA
| | | | | | - Jerry Bagel
- f Psoriasis Treatment Center of Central New Jersey , East Windsor , NJ , USA
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Rogalski C. Calcipotriol/betamethasone for the treatment of psoriasis: efficacy, safety, and patient acceptability. PSORIASIS-TARGETS AND THERAPY 2015; 5:97-107. [PMID: 29387586 PMCID: PMC5683117 DOI: 10.2147/ptt.s63127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background One of the advances in the treatment of plaque-type psoriasis is combined local therapy with calcipotriol and betamethasone. To provide both ingredients in a two-compound product, efforts have been made to unite calcipotriol and betamethasone because they are usually inactivated when present in the same formulation. This aspect was resolved when carefully designed vehicle components were invented (gel and ointment). This article reviews the efficacy, safety, and patient acceptability of calcipotriol/betamethasone dipropionate. Methods A literature search of all articles published until February 2015 was performed, including the largest medical databases. The search strategy for evaluating the main topics of this review – efficacy, safety, and patient acceptability – was defined before checking the publications. Results Seventy references were found and checked for relevance. For efficacy, the proportion of patients whose psoriasis improved was always significantly higher in the two-compound group compared to the group treated with the individual substances. In the context of safety, the fixed combination was generally associated with a lower risk of adverse events. In terms of patient acceptability, the fixed combination led to a significant improvement in quality of life. The two-compound product was more convenient to handle and time saving compared to former treatments. Conclusion Calcipotriol/betamethasone dipropionate in a fixed combination is an effective and well-tolerated medication in mild-to-moderate psoriasis of body and scalp and, in addition, is an evidence-based treatment modality.
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Affiliation(s)
- Christina Rogalski
- Medical Business Development, edia. con gemeinnützige GmbH, Leipzig, Saxony, Germany
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14
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Burroni AG, Fassino M, Torti A, Visentin E. How do disease perception, treatment features, and dermatologist-patient relationship impact on patients assuming topical treatment? An Italian survey. PATIENT-RELATED OUTCOME MEASURES 2015; 6:9-17. [PMID: 25733940 PMCID: PMC4337690 DOI: 10.2147/prom.s76551] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Psoriasis largely affects daily activities and social interactions and has a strong impact on patients’ quality of life. Psoriatic patients have different attitudes toward their condition. Topical medications are essential for the treatment of psoriasis, but the majority of patients do not adhere to these therapies. Objective The history of treatment success or failure seems to influence patient attitude toward topical therapy. Therefore, it is important to understand the psychological, experiential, and motivational aspects that could be critical for treatment adherence, and to describe the different attitudes toward topical treatment. Furthermore, the physician–patient relationship and the willingness to trust the dermatologist may have a substantial role in encouraging or discouraging patients’ attitudes toward topical therapy. Methods A survey was designed to collect aspects that could be relevant to understanding different patient attitudes toward psoriasis and its treatments. A total of 495 self-administered questionnaires compiled by psoriatic patients were analyzed from 20 Italian specialized hospital centers in order to provide a nationwide picture. Results Psoriatic patients have different perceptions and experiences in relation to their condition: half of them consider psoriasis as a disease, while the other half consider psoriasis as a disorder or a nuisance. Topical therapy is the most widely used treatment, even though it is not considered the most effective one and often perceived to be cosmetic. The main findings are: 1) inadequate patient education about this disease, 2) lack of information about topical treatment, and 3) lack of results within the expected time frame. Furthermore, physicians need to build a good relationship with psoriatic patients in order to motivate them, to trust in their care, and to adhere to treatment. Conclusion This survey adds new and important details about daily life and well-being and the needs of psoriatic patients, providing suggestions for dermatologists to improve patients management.
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Affiliation(s)
- Anna Graziella Burroni
- IRCCS University Hospital San Martino, IST National Institute for Cancer Research, Genoa, Italy
| | - Mariella Fassino
- Department of Psychology, Specialization School in Clinical Psychology, University of Turin, Turin, Italy
| | | | - Elena Visentin
- HTA and Scientific Support, CSD Medical Research Srl, Milan, Italy
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15
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Reich K, Zschocke I, Bachelez H, de Jong EMGJ, Gisondi P, Puig L, Warren RB, Mrowietz U. Efficacy of a fixed combination of calcipotriol/betamethasone dipropionate topical gel in adult patients with mild to moderate psoriasis: blinded interim analysis of a phase IV, multicenter, randomized, controlled, prospective study. J Eur Acad Dermatol Venereol 2014; 29:1156-63. [PMID: 25346093 DOI: 10.1111/jdv.12774] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 09/12/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psoriasis is a common, chronic, inflammatory skin disease with the majority of individuals having limited disease, treated with topical medication. However, special attributes of topical treatments like galenic/cosmetic properties or an inconvenient treatment schedule may result in low preference for topical treatments. Hence, there is strong medical need for a topical medication, which is highly efficacious, easy-to-use and preferred by both physicians and patients. OBJECTIVE Blinded interim analysis with the purpose to assess efficacy of (both from the physician's and patient's perspective) and the patients' preference with a highly efficacious and easy-to-use fixed combination of calcipotriol/betamethasone dipropionate topical gel after 8 weeks of once daily treatment in a large patient population. METHODS In this phase IV, international, multicentre, randomized, controlled, prospective, parallel group study, adult patients with active, mild to moderate psoriasis despite previous topical psoriasis treatment, i.e. unsuccessful in the 8 weeks preceding study participation, are followed over 64 weeks. During the first 8 weeks the patients apply their medication once a day followed by a 56-weeks maintenance period according to SmPC. Blinded interim analysis of all patients included demographics, Physician's Global Assessment, the novel Patient's self Global Assessment (PsGA) and Patient Preference Questionnaire (PPQ). RESULTS 1795 patients were analysed. At week 8, 36.5% of the physicians rated the patients' psoriasis as clear/almost clear. Similarly, based on the patients' self-assessment, 34.2% had a clear/almost clear score of PsGA in week 8. Analysis of the PPQ showed that the vast majority of the patients judged their 8-week treatment to be preferable compared with their previous treatments. CONCLUSION Results of this blinded interim analysis indicate that the fixed combination of calcipotriol/betamethasone dipropionate gel is highly efficacious and preferred by the majority of analysed patients.
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Affiliation(s)
- K Reich
- Dermatologikum Hamburg, Hamburg, Germany
| | | | - H Bachelez
- Sorbonne Paris Cité Université Paris-Diderot, Department of Dermatology, AP-HP Hôpital Saint-Louis, Paris, France
| | - E M G J de Jong
- Radboud university medical centre, Nijmegen, The Netherlands
| | - P Gisondi
- University of Verona Dermatology and Venerology Section, Verona, Italy
| | - L Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - R B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - U Mrowietz
- Psoriasis Zentrum Abteilung Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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West CE, Narahari S, Feldman SR. Calcipotriene foam, 0.005% in mild-to-moderate plaque psoriasis. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.11.76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Sitter B, Johnsson MK, Halgunset J, Bathen TF. Metabolic changes in psoriatic skin under topical corticosteroid treatment. BMC DERMATOLOGY 2013; 13:8. [PMID: 23945194 PMCID: PMC3751591 DOI: 10.1186/1471-5945-13-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 08/08/2013] [Indexed: 02/08/2023]
Abstract
Background MR spectroscopy of intact biopsies can provide a metabolic snapshot of the investigated tissue. The aim of the present study was to explore the metabolic pattern of uninvolved skin, psoriatic skin and corticosteroid treated psoriatic skin. Methods The three types of skin biopsy samples were excised from patients with psoriasis (N = 10). Lesions were evaluated clinically, and tissue biopsies were excised and analyzed by one-dimensional 1H MR spectroscopy. Relative levels were calculated for nine tissue metabolites. Subsequently, relative amounts of epidermis, dermis and subcutaneous tissue were scored by histopathological evaluation of HES stained sections. Results Seven out of 10 patients experienced at least 40% reduction in clinical score after corticosteroid treatment. Tissue biopsies from psoriatic skin contained lower levels of the metabolites myo-inositol and glucose, and higher levels of choline and taurine compared to uninvolved skin. In corticosteroid treated psoriatic skin, tissue levels of glucose, myo-inositol, GPC and glycine were increased, whereas choline was reduced, in patients with good therapeutic effect. These tissue levels are becoming more similar to metabolite levels in uninvolved skin. Conclusion This MR method demonstrates that metabolism in psoriatic skin becomes similar to that of uninvolved skin after effective corticosteroid treatment. MR profiling of skin lesions reflect metabolic alterations related to pathogenesis and treatment effects.
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Affiliation(s)
- Beathe Sitter
- Department of Technology, Sør Trøndelag University College, 7004 Trondheim, Norway.
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18
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Puig L, Carrascosa J, Belinchón I, Fernández-Redondo V, Carretero G, Ruiz-Carrascosa J, Careaga J, de la Cueva P, Gárate M, Ribera M. Adherencia y satisfacción del paciente y características organolépticas y de uso de los tratamientos tópicos utilizados para la psoriasis: Consenso Delphi del panel de expertos y miembros del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:488-96. [DOI: 10.1016/j.ad.2012.12.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 12/10/2012] [Accepted: 12/12/2012] [Indexed: 11/25/2022] Open
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Adherence and Patient Satisfaction With Topical Treatment in Psoriasis, and the Use, and Organoleptic Properties of Such Treatments: A Delphi Study With an Expert Panel and Members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.adengl.2012.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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20
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Bracke S, Desmet E, Guerrero-Aspizua S, Tjabringa SG, Schalkwijk J, Van Gele M, Carretero M, Lambert J. Identifying targets for topical RNAi therapeutics in psoriasis: assessment of a new in vitro psoriasis model. Arch Dermatol Res 2013; 305:501-12. [PMID: 23775225 DOI: 10.1007/s00403-013-1379-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 06/05/2013] [Accepted: 06/10/2013] [Indexed: 12/19/2022]
Abstract
Diseases of the skin are amenable to RNAi-based therapies and targeting key components in the pathophysiology of psoriasis using RNAi may represent a successful new therapeutic strategy. We aimed to develop a straightforward and highly reproducible in vitro psoriasis model useful to study the effects of gene knockdown by RNAi and to identify new targets for topical RNAi therapeutics. We evaluated the use of keratinocytes derived from psoriatic plaques and normal human keratinocytes (NHKs). To induce a psoriatic phenotype in NHKs, combinations of pro-inflammatory cytokines (IL-1α, IL-17A, IL-6 and TNF-α) were tested. The model based on NHK met our needs of a reliable and predictive preclinical model, and this model was further selected for gene expression analyses, comprising a panel of 55 psoriasis-associated genes and five micro-RNAs (miRNAs). Gene silencing studies were conducted by using small interfering RNAs (siRNAs) and miRNA inhibitors directed against potential target genes such as CAMP and DEFB4 and miRNAs such as miR-203. We describe a robust and highly reproducible in vitro psoriasis model that recapitulates expression of a large panel of genes and miRNAs relevant to the pathogenesis of psoriasis. Furthermore, we show that our model is a powerful first step model system for testing and screening RNAi-based therapeutics.
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Affiliation(s)
- S Bracke
- Department of Dermatology 2K4, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
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21
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Badilli U, Amasya G, Şen T, Tarimci N. Topical emulgel formulation containing inclusion complex of calcipotriol with cyclodextrin. J INCL PHENOM MACRO 2013. [DOI: 10.1007/s10847-013-0293-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Colombo GL, Di Matteo S, Bruno G, Girolomoni G, Vena GA. Calcipotriol and betamethasone dipropionate in the treatment of mild-to-moderate psoriasis: a cost-effectiveness analysis of the ointment versus gel formulation. CLINICOECONOMICS AND OUTCOMES RESEARCH 2012; 4:261-8. [PMID: 23028233 PMCID: PMC3446829 DOI: 10.2147/ceor.s35046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Psoriasis is a chronic inflammatory skin disease with a major impact on the quality of life of affected individuals. Topical therapy has an important role in the treatment of psoriasis. Poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of medication. Methods A cost-minimization analysis was performed with the purpose of assessing the use of a gel containing calcipotriol and betamethasone dipropionate (Dovobet® gel) versus the ointment formulation (Dovobet ointment) in the treatment of psoriasis. The analysis was carried out using a Markov model with a one-year time horizon in a hypothetical cohort of patients with a Psoriasis Area and Severity Index score < 10. The model simulates different therapy adherence scenarios for the two different formulations. Results The Dovobet gel strategy allows a 5% reduction in the number of patients who could potentially be treated with more expensive therapies (biologics and conventional systemic drugs) in comparison with the Dovobet ointment strategy, with a consequent impact on costs for the National Healthcare Service. The total annual cost of Dovobet gel is about €407.00 per patient, ie, 19% less that the total cost of about €500.00 of the Dovobet ointment strategy. The base case results were then examined by sensitivity analysis and budget impact analysis to correlate the various scenarios of Dovobet gel use with cost savings to the National Healthcare Service. Conclusion The Dovobet gel strategy seems more acceptable to patients, shows better overall adherence, and appears to be favorable from the pharmacoeconomic point of view than the ointment formulation for treatment of patients with mild-to-moderate psoriasis.
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Affiliation(s)
- Giorgio L Colombo
- University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy ; S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy
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Shutty B, West C, Pellerin M, Feldman S. Apremilast as a treatment for psoriasis. Expert Opin Pharmacother 2012; 13:1761-70. [DOI: 10.1517/14656566.2012.699959] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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BAKULEV AL, KRAVHCHENYA SS. On the efficiency and safety of application of the short course of clobetasol propionate at patients, suffering from psoriasis in the progression phase. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Research target: to evaluate the efficiency and safety of the application of clobetasol propionate ointment (Cloveit ointment for external application, Jelfa) at 60 patients, suffering from plaque psoriasis of average gravity in dermatosis progression phase. Material and methods. The panel comprises 60 patients, suffering from psoriasis (36 men and 24 women) in the age of 25-55 y.o. (the average age is 35,4 ± 2,1 years). The disease continuity was between 6 months and 12 years. The therapeutic efficiency was evaluated with PASI, PGA indices, аs well as with data of ultrasonographic research. Results. Initiating seven days course of the topical therapy with clobetasol propionate, included in the standard comprehensive treatment, favors the transfer of the psoriatic process in the stabilization phase and is not accompanied with clinical and sub-clinical features of skin atrophy.
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Uva L, Miguel D, Pinheiro C, Antunes J, Cruz D, Ferreira J, Filipe P. Mechanisms of action of topical corticosteroids in psoriasis. Int J Endocrinol 2012; 2012:561018. [PMID: 23213332 PMCID: PMC3508578 DOI: 10.1155/2012/561018] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/14/2012] [Accepted: 10/20/2012] [Indexed: 11/17/2022] Open
Abstract
Psoriasis is a lifelong, chronic, and immune-mediated systemic disease, which affects approximately 1-3% of the Caucasian population. The different presentations of psoriasis require different approaches to treatment and appropriate prescriptions according to disease severity. The use of topical therapy remains a key component of the management of almost all psoriasis patients, and while mild disease is commonly treated only with topical agents, the use of topical therapy as adjuvant therapy in moderate-to-severe disease may also be helpful. This paper focuses on the cutaneous mechanisms of action of corticosteroids and on the currently available topical treatments, taking into account adverse effects, bioavailability, new combination treatments, and strategies to improve the safety of corticosteroids. It is established that the treatment choice should be tailored to match the individual patient's needs and his/her expectations, prescribing to each patient the most suitable vehicle.
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Affiliation(s)
- Luís Uva
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
- *Luís Uva:
| | - Diana Miguel
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Catarina Pinheiro
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Joana Antunes
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Diogo Cruz
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - João Ferreira
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
| | - Paulo Filipe
- Clínica Universitária de Dermatologia, Faculdade de Medicina de Lisboa, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
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