Tazarotene 0.1% gel plus corticosteroid cream in the treatment of plaque psoriasis.
BACKGROUND
Topical corticosteroids are often used in the treatment of psoriasis, but long-term use may be associated with serious adverse events such as tachyphylaxis or atrophy of the skin. Tazarotene, a new topical retinoid, has demonstrated significant clinical benefits but can cause mild to moderate local irritation.


OBJECTIVE
We evaluate whether a combination treatment of topical tazarotene and a topical corticosteroid would increase efficacy while reducing the incidence of local adverse events associated with a topical retinoid.


METHODS
Three hundred patients enrolled in an investigator-masked study were randomly assigned to 1 of 4 treatment groups: tazarotene 0.1% gel in combination with placebo cream, or with a low-, mid-, or high-potency corticosteroid cream, for 12 weeks of treatment and a posttreatment follow-up at week 16.


RESULTS
Tazarotene 0.1% gel in combination with a mid- or high-potency corticosteroid, when compared with tazarotene plus placebo cream, achieved significantly greater reductions in scaling, erythema, and overall lesional severity, and a decreased incidence of adverse events.


CONCLUSIONS
All tazarotene combinations (including tazarotene plus placebo) were highly effective in rapidly reducing the severity of psoriasis. Combining tazarotene with a topical corticosteroid increased efficacy while reducing the incidence of local adverse events.
Lebwohl
M G
MG
Mount Sinai Hospital, New York, NY 10029, USA.
Breneman
D L
DL
Goffe
B S
BS
Grossman
J R
JR
Ling
M R
MR
Milbauer
J
J
Pincus
S H
SH
Sibbald
R G
RG
Swinyer
L J
LJ
Weinstein
G D
GD
Lew-Kaya
D A
DA
Lue
J C
JC
Gibson
J R
JR
Sefton
J
J
D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D002170:Canada; D004359:Drug Therapy, Combination; D005260:Female; D005782:Gels; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009539:Nicotinic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009824:Ointments; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D012176:Retinoids
D000305:Adrenal Cortex Hormones; D005782:Gels; D007641:Keratolytic Agents; D009539:Nicotinic Acids; D009824:Ointments; C086827:tazarotene; D012176:Retinoids