title: A randomized, multicenter study of calcipotriene ointment and clobetasol propionate foam in the sequential treatment of localized plaque-type psoriasis: short- and long-term outcomes.
abstract: BACKGROUND
  The merit of topical sequential therapy involving clobetasol foam and calcipotriene ointment has not been experimentally demonstrated.
  
  
  OBJECTIVE
  We sought to assess the short-term efficacy of twice-daily clobetasol foam plus calcipotriene ointment compared with either agent alone as monotherapy and to compare long-term use of weekday calcipotriene ointment with or without clobetasol foam weekend pulse therapy.
  
  
  METHODS
  Eighty-six subjects with plaque-type psoriasis received twice-daily treatment with clobetasol foam plus calcipotriene ointment or either agent as monotherapy for 2 weeks. Subjects in the combination group who achieved remission received weekday calcipotriene plus weekend pulse therapy with either clobetasol foam or vehicle for 6 months.
  
  
  RESULTS
  After 2 weeks, psoriasis scores were significantly lower (P < .001) in the combination therapy group (adjusted trunk lesion score = 0.67) compared with monotherapy with either agent (lesion scores = 1.40 calcipotriene, 1.13 clobetasol foam). During the follow-up "weekday-weekend" phase, after 6 months, weekend pulse clobetasol foam was associated with a trend toward greater maintenance of remission compared with vehicle (92% improvement of trunk lesion vs 62%).
  
  
  CONCLUSIONS
  Small sample size may have hampered the detection of statistical significance during long-term therapy.
  
  
  CONCLUSIONS
  The combination of clobetasol foam and calcipotriene ointment is significantly more effective than monotherapy for short-term treatment. Weekday calcipotriene plus weekend pulse clobetasol foam shows a consistent trend toward greater maintenance of remission.
authors.affiliation: UCSF Psoriasis and Phototherapy Treatment Center, Department of Dermatology, University of California, San Francisco 94118, USA.
authors.forename: John
authors.initials: J
authors.lastname: Koo
authors.forename: Robin R
authors.initials: RR
authors.lastname: Blum
authors.forename: Mark
authors.initials: M
authors.lastname: Lebwohl
mesh_terms: D000328:Adult; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002990:Clobetasol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004304:Dosage Forms; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009824:Ointments; D011565:Psoriasis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004304:Dosage Forms; D009824:Ointments; C055085:calcipotriene; D002990:Clobetasol; D002117:Calcitriol