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Jo SJ, Park CJ, Bang CH, Jeong KH, Shin BS, Kim DH, Song HJ, Lee JH, Kim Y, Choi S, Youn SW. Effectiveness of calcipotriol/betamethasone dipropionate aerosol foam in patients with small versus large plaque psoriasis in routine practice in South Korea. J Dermatol 2024; 51:1010-1016. [PMID: 38716641 DOI: 10.1111/1346-8138.17253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/14/2024] [Accepted: 04/12/2024] [Indexed: 07/04/2024]
Abstract
Small plaque psoriasis is the typical form of chronic plaque psoriasis affecting adults in South Korea. The effectiveness of calcipotriol/betamethasone dipropionate (Cal/BD) aerosol foam for large and small psoriasis plaques has not previously been examined. We performed a post hoc analysis of a recent, 4-week observational study of Cal/BD aerosol foam use in routine clinical practice in South Korea. Investigator Global Assessment response ([IGA] 0/1 at week 4), Patient Global Assessment response ([PaGA] 0/1 at week 4), change in Psoriasis Area and Severity Index (PASI), changes in psoriasis symptom scores, change in the Dermatology Life Quality Index (DLQI), and the proportion of patients achieving DLQI ≤5 were analyzed for patients with small (≤5 cm; n = 131) or large (>5 cm; n = 35) baseline plaque size. IGA response rates were similar for patients with small and large plaques (59.5% and 51.4% respectively). Similarly, there was no significant difference between the small and large groups in mean change in PASI (-2.20 vs -3.34), the proportions of patients with DLQI ≤5 (62.3% vs 54.3%) or PaGA 0/1 (29.2% vs 40.0%). Mean improvements in DLQI (-4.04 vs -6.20) and in psoriasis symptoms including itching (-1.50 vs -2.83), sleep loss (-0.67 vs -1.89), dryness (-1.57 vs -2.97), scaling (-1.21 vs -3.57), and redness (-1.17 vs -3.11) were greater in patients with large plaques than those with small plaques. Itching and DLQI differences were not statistically significant after adjustment for baseline characteristics. Stratification by body surface area affected eliminated statistically significant differences between the groups for most outcomes. In conclusion, this analysis suggests that Cal/BD aerosol foam is an effective, well-accepted treatment for adult patients with the small plaques typical of chronic plaque psoriasis in South Korea, as well as for those with large plaques.
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Affiliation(s)
- Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Dermatology, Seoul National University Hospital, Seoul, South Korea
| | - Chul-Jong Park
- Department of Dermatology, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, South Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Ki-Heon Jeong
- Department of Dermatology, KyungHee University Medical Center, Seoul, South Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Hospital, Gwangju, South Korea
| | - Dong Hyun Kim
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Hae Jun Song
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, South Korea
| | - Ju-Hee Lee
- Department of Dermatology, Severance Hospital, Seoul, South Korea
| | | | - Sun Choi
- LEO Pharma Limited, Seoul, South Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University College of Medicine, Seongnam, South Korea
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, South Korea
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Science of, and insights into, thermodynamic principles for dermal formulations. Drug Discov Today 2023; 28:103521. [PMID: 36754143 DOI: 10.1016/j.drudis.2023.103521] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
Studies have demonstrated the significant role of the thermodynamic activity of drugs in skin drug delivery. This thermodynamic activity works as a driving force for increasing/improving the absorption of drugs by the skin. It can be changed according to the physicochemical parameters (e.g., solubility, partition coefficient, and water activity) of the drug in the vehicle. Thermodynamic principles have been used for the development of novel topical and transdermal delivery systems, demonstrating the importance of thermodynamic activity in enhancing drug permeation through the skin. In this review, we provide insights into thermodynamic principles and their roles in optimizing topical and transdermal drug delivery systems.
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Wang C, Hao R, Peng B, Chang J, Chen S, Chen Y, Yin X, Que Y, Fan C, Xu Y. Dissolvable hyaluronic acid microneedles loaded with β-Elemene for the treatment of psoriasis. Front Pharmacol 2022; 13:1067051. [PMID: 36467042 PMCID: PMC9715959 DOI: 10.3389/fphar.2022.1067051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2023] Open
Abstract
The pathology of psoriasis involves the over-proliferation of keratinocytes, exaggerated inflammation of keratinocytes, and infiltration of inflammatory cells such as macrophages (Mø), etc. The therapeutic outcomes of current treatment targeting one single pathological process are less than satisfactory. Based on their diverse biological activities, natural products offer a potential solution to this problem. In this study, we investigated the effects of β-Elemene (ELE) on both psoriatic keratinocytes and M1-type Mø (M1-Mø) in vitro. Hyaluronic acid (HA) microneedles loaded with ELE (HA-ELE-MN) were also fabricated and tested for the treatment of psoriasis in vivo using an imiquimod (IMQ)-induced psoriatic mice model. Our data suggest that ELE induces apoptosis and inhibits inflammation of psoriatic keratinocytes. In addition, ELE attenuates the expression of inflammatory cytokines secreted from M1-Mø, thus indirectly inhibiting the inflammation of keratinocytes. Furthermore, HA-ELE-MN has been found to significantly alleviate symptoms in an IMQ-induced psoriatic mice model by inducing keratinocytes apoptosis, suppressing keratinocytes proliferation, and inhibiting M1-Mø infiltration. Taken together, this study demonstrates that ELE can be used for the treatment of psoriasis by targeting both keratinocytes and M1-Mø, which provides a potential novel reagent for psoriasis treatment.
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Affiliation(s)
- Chun Wang
- College of Pharmaceutical Science, Dali University, Dali, China
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Ruiqi Hao
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Baowei Peng
- College of Pharmaceutical Science, Dali University, Dali, China
| | - Jiang Chang
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Shisheng Chen
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yanxin Chen
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Xiaohang Yin
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Yumei Que
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Chen Fan
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Yuhong Xu
- College of Pharmaceutical Science, Dali University, Dali, China
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Jo SJ, Park CJ, Bang CH, Jeong KH, Shin BS, Kim DH, Park HJ, Kim BS, Song HJ, Lee JH, Youn SW. Calcipotriol/betamethasone aerosol foam (Enstilum) for the topical treatment of psoriasis vulgaris in routine practice in Korea: A prospective, noninterventional, multicenter study of treatment outcomes and patient satisfaction. J Dermatol 2022; 49:1085-1095. [PMID: 35848089 DOI: 10.1111/1346-8138.16519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/20/2022] [Accepted: 06/25/2022] [Indexed: 11/27/2022]
Abstract
An innovative foam formulation for the fixed-dose combination of calcipotriol and betamethasone dipropionate (Cal/BD) has recently become available for the treatment of psoriasis vulgaris. Observational studies of patients treated with Cal/BD foam in routine practice have been conducted in several Western countries, but there are limited data on outcomes in Asian patients. We performed a prospective, open-label, noncomparative, noninterventional study to investigate treatment outcomes and satisfaction in adult patients receiving Cal/BD foam for psoriasis vulgaris in dermatological centers and outpatient clinics in Korea. Data were collected at the time of enrollment (Visit 1) and at a routine clinic visit ~4 weeks later (Visit 2). In total, 218 patients were enrolled, of whom 175 were included in the safety analysis set (58.9% male; mean age ± standard deviation 46.7 ± 15.1 years; use of Cal/BD foam at least once daily 74.3%). Of the safety analysis set, 166 patients had at least mild psoriasis (Investigator Global Assessment [IGA] ≥ 2) and were analyzed for treatment outcomes and satisfaction. Of the 166 patients, 71.7% had mild psoriasis (IGA 2) at baseline. The majority (57.8%) achieved an IGA of 0/1 (clear/almost clear) at Visit 2. The Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) showed significant improvements from Visit 1 to Visit 2 (PASI -2.4 ± 3.0, DLQI -4.5 ± 5.2, both P < 0.0001). Most of the patients were satisfied with the Cal/BD foam treatment; 77.0%, 60.0%, and 73.9% were satisfied in terms of effectiveness, ease of use, and global satisfaction, respectively. In the safety analysis set, adverse events were reported in 13 patients (7.4%). In conclusion, this first Korean real-world study of Cal/BD foam shows improvement of lesions and health-related quality of life after 4 weeks of treatment, with high global satisfaction and good overall tolerability and safety.
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Affiliation(s)
- Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
| | - Chul-Jong Park
- Department of Dermatology, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, South Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Ki-Heon Jeong
- Department of Dermatology, KyungHee University Medical Center, Seoul, South Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Hospital, Gwangju, South Korea
| | - Dong Hyun Kim
- Department of Dermatology, Cha University Bundang Medical Center, Seongnam, South Korea
| | - Hai-Jin Park
- Department of Dermatology, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University Hospital, Busan, South Korea
| | - Hae-Jun Song
- Department of Dermatology, Korea University Guro Hospital, Seoul, South Korea
| | - Ju-Hee Lee
- Department of Dermatology, Severance Hospital, Seoul, South Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University College of Medicine, and Seoul National University Bundang Hospital, Seongnam, South Korea
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Jalili A, Yosipovitch G. Fixed-dose combination calcipotriol/betamethasone dipropionate foam provides a rapid onset of action, effective itch relief and improves patient quality of life. J Eur Acad Dermatol Venereol 2021; 35 Suppl 1:20-27. [PMID: 33619778 PMCID: PMC7986201 DOI: 10.1111/jdv.17085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022]
Abstract
The physical symptoms of psoriasis vulgaris (chronic plaque psoriasis), such as itch and itch‐related sleep loss, and the psychological impact of visible plaques on the body, all contribute to significantly reduced health‐related quality of life (HRQoL) in patients with psoriasis. In fact, the deterioration of HRQoL in patients with psoriasis is similar to patients with other chronic conditions, such as cancer and cardiovascular diseases. Rapid and effective improvements in HRQoL and itch‐related outcomes would therefore be highly valued by patients and may even improve adherence to treatment. In this article, we summarise previously published data assessing the impact of fixed‐dose combination calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) on itch relief, quality of sleep, onset of action and HRQoL. Findings across multiple analyses indicate that Cal/BD foam provides significant improvements in itch, itch‐related sleep loss and HRQoL compared with vehicle foam or Cal/BD gel comparators. Additionally, the benefits of Cal/BD foam were recorded earlier than these comparators, often within 1 week of treatment, indicating a rapid onset of action. With the published data to hand, it is clear that Cal/BD foam provides significant improvements in the outcomes that matter most to patients and should be considered an effective topical treatment for psoriasis. Video abstract
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Affiliation(s)
- A Jalili
- Dermatology & Skin Care, Bürgenstock Medical Center, Obbürgen, Switzerland
| | - G Yosipovitch
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery & Miami Itch Center, Miller School of Medicine, Miami, FL, USA
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Armstrong A, Gerdes S. Calcipotriol/betamethasone dipropionate foam demonstrates comparable efficacy to clinical trial data in the real world, improves patient satisfaction and is cost-effective. J Eur Acad Dermatol Venereol 2021; 35 Suppl 1:28-34. [PMID: 33619780 DOI: 10.1111/jdv.17084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/01/2020] [Indexed: 12/30/2022]
Abstract
Real-world evidence studies are becoming increasingly important in providing insight into clinical effectiveness and safety, economic outcomes, patient-reported outcomes and health-related quality of life of treatments in the clinical setting. These studies also help to complement data reported in clinical studies. Fixed-dose combination calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) is a topical agent used for the treatment of psoriasis vulgaris. In clinical studies, Cal/BD foam has demonstrated a significantly greater efficacy and rapid onset of action compared with both single and combination formulations such as ointments and gels. To date, three observational studies have examined the real-world efficacy and safety of Cal/BD foam in clinical practice in the United States, Germany and Spain. Data gathered from these studies reinforce the positive findings reported in clinical studies assessing Cal/BD foam for the treatment of psoriasis and demonstrate improved patient satisfaction with Cal/BD foam. Using Cal/BD foam has been shown to be cost-effective based on results from randomised clinical trials and cost-effective analysis. As such, Cal/BD foam has the potential to lower treatment costs by reducing the need for some patients to progress to more expensive treatments, such as phototherapy and biologics. Cal/BD foam is therefore a cost-effective solution for the treatment of psoriasis vulgaris that should be considered when prescribing topicals.
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Affiliation(s)
- A Armstrong
- University of Southern California, Los Angeles, CA, USA
| | - S Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
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Lebwohl M, Warren RB. Editorial: fixed-dose combination calcipotriol/betamethasone dipropionate foam in the treatment of patients with psoriasis. J Eur Acad Dermatol Venereol 2021; 35 Suppl 1:3-4. [PMID: 33619781 PMCID: PMC8151871 DOI: 10.1111/jdv.17026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Video abstract
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Affiliation(s)
- M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, University of Manchester, Manchester, UK
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