Efficacy of vitamin D3 derivatives in the treatment of psoriasis vulgaris: a preliminary report.
The efficacy of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and the new analogue calcipotriene (MC 903) in the treatment of psoriasis was investigated. Eight patients with psoriasis were enrolled in a pilot study with systemically administered vitamin D3 and were given 1,25(OH)2D3 (Rocaltrol; Hoffmann-La Roche) in dosages from 0.5 microgram to 2 micrograms/day for a 6-month trial. In one patient, the psoriatic plaques resolved within 2 months after treatment (0.5 microgram/day) was initiated. Moderate improvement was noted in one other patient (1 microgram/day). The serum level of 1,25(OH)2D before treatment was not less than the normal range of the adult population. Side effects of systemically administered 1,25(OH)2D3 included a dose-dependent increase in the 24-hour urinary calcium excretion and a decrease in the total number of platelets. Seven patients with symmetric plaque-type psoriasis were treated topically with 2 micrograms/g of 1,25(OH)2D3 in petrolatum. During 3 months of follow-up, mild improvement was noted in three patients. Five patients in the calcipotriene study were part of a nationwide double-blind placebo-controlled trial by Bristol-Myers Squibb. Moderate to marked improvement was noted in the two patients who received 50 micrograms/g of calcipotriene topically. The three patients who received placebo showed no response. We conclude that a subset of patients with psoriasis responds well to 1,25(OH)2D3. Calcipotriene is efficacious and an excellent alternative to topically applied corticosteroids.
el-Azhary
R A
RA
Department of Dermatology, Mayo Clinic Jacksonville, FL 32224.
Peters
M S
MS
Pittelkow
M R
MR
Kao
P C
PC
Muller
S A
SA
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism
D003879:Dermatologic Agents; C055085:calcipotriene; D002762:Cholecalciferol; D002117:Calcitriol