Calcitriol 3 microg g-1 ointment in combination with ultraviolet B phototherapy for the treatment of plaque psoriasis: results of a comparative study.
BACKGROUND
Combinations of topical treatments and ultraviolet (UV) B phototherapy for plaque psoriasis may be more beneficial than either type of treatment used alone.


OBJECTIVE
To determine the efficacy of calcitriol 3 microg g-1 ointment in combination with UVB phototherapy in treating plaque psoriasis.


METHODS
Calcitriol ointment with UVB was compared with vehicle plus UVB in a randomized, double-blind study in 104 patients.


RESULTS
Mean global improvement scores for both groups increased over the 8-week study period; there was a statistically significant difference (P < 0.05) in favour of the calcitriol/UVB combination from week 1. At end-point, 45% of the calcitriol/UVB group showed considerable improvement or clearing of psoriasis, compared with 21% of the control group. The superiority of calcitriol plus UVB was also reflected in the global severity and Psoriasis Area and Severity Index (PASI) scores; at end-point the mean percentage decrease in PASI score was 65% for the calcitriol/UVB group and 43% for vehicle/UVB (P = 0.0014). The incidence of skin-related adverse events was low (< 12%) and similar in the two treatment groups. No clinically significant changes in blood chemistry, in particular calcium levels, occurred. The greater efficacy of combined calcitriol and phototherapy allowed a 34% decrease in total UVB exposure.


CONCLUSIONS
Calcitriol 3 microg g-1 ointment and UVB phototherapy in combination provides a promising therapy for managing chronic plaque psoriasis.
University Hospital of Dermatology, Hamburg, Germany. JohannesRing@lrz/tu.muenchen.de
J
J
Ring
L
L
Kowalzick
E
E
Christophers
W B
WB
Schill
E
E
Schöpf
M
M
Ständer
H H
HH
Wolff
P
P
Altmeyer
D000328:Adult; D000368:Aged; D002117:Calcitriol / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D011829:Radiation Dosage; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D003879:Dermatologic Agents; D009824:Ointments; D002117:Calcitriol