title: Combination of calcipotriene (Dovonex) ointment and tazarotene (Tazorac) gel versus clobetasol ointment in the treatment of plaque psoriasis: a pilot study.
abstract: BACKGROUND
  Both calcipotriene and tazarotene have been shown to be effective in the treatment of psoriasis. No study has evaluated the effect of using both agents simultaneously.
  
  
  OBJECTIVE
  Our purpose was to evaluate the effectiveness of combination treatment of psoriasis with calcipotriene ointment and tazarotene gel by comparing them with clobetasol ointment, a class I topical corticosteroid. A secondary objective was to evaluate the clinical compatibility of applying both agents at the same time.
  
  
  METHODS
  This pilot study was a prospective, single-center, open-label, right/left comparison of 28 lesion pairs in 15 patients. It consisted of a 2-week treatment phase, followed by a 4-week post-treatment observation phase.
  
  
  RESULTS
  All 15 patients completed the treatment phase of the study. At the end of the active treatment phase (end of week 2), calcipotriene- and tazarotene-treated lesions showed nearly identical reductions in scaling (P =.93), plaque elevation (P =.76), and overall lesional severity scores (P =.29) compared with their matched clobetasol-treated counterparts. Erythema improved significantly more in clobetasol-treated lesions (P <.05) during the treatment period, but differences became statistically insignificant during the post-treatment period (;P =.20). No patients had significant irritation from the treatments. During the post-treatment phase (weeks 3-6), all lesions worsened; plaque elevation returned somewhat more rapidly in calcipotriene- and tazarotene-treated lesions (P <.01), whereas changes in scaling, erythema, and overall lesional severity were not significantly different between the two treatment groups (P >.05).
  
  
  CONCLUSIONS
  The nonsteroid combination of twice-daily calcipotriene ointment and once-daily tazarotene gel was not statistically different from twice-daily application of the class I corticosteroid clobetasol ointment in reducing psoriatic scaling, plaque elevation, and overall lesional severity over a 2-week period. There does not seem to be any chemical incompatibility between calcipotriene ointment and tazarotene gel that is clinically significant.
authors.affiliation: Department of Dermatology, University of California at San Francisco, 94118, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Bowman
authors.forename: Jack E
authors.initials: JE
authors.lastname: Maloney
authors.forename: John Y M
authors.initials: JY
authors.lastname: Koo
mesh_terms: D000279:Administration, Cutaneous; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001132:Arm; D002117:Calcitriol / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D002990:Clobetasol / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004550:Elbow; D005260:Female; D005782:Gels; D005938:Glucocorticoids; D006801:Humans; D007866:Leg; D008297:Male; D009539:Nicotinic Acids / Q000008:administration & dosage*; D009824:Ointments; D010865:Pilot Projects; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index; D013909:Thorax; D016896:Treatment Outcome; D012176:Retinoids
chemical_list: D000893:Anti-Inflammatory Agents; D002117:Calcitriol; D002990:Clobetasol; D003879:Dermatologic Agents; D005782:Gels; D005938:Glucocorticoids; D009539:Nicotinic Acids; D009824:Ointments; C055085:calcipotriene; C086827:tazarotene; D012176:Retinoids