Calcipotriol plus betamethasone dipropionate aerosol foam versus apremilast, methotrexate, acitretin, or fumaric acid esters


02 Jan 2019 11:33 Ricerca


BACKGROUND: Plaque psoriasis has significant impact on patients' quality of life. Topical therapy is considered the treatment mainstay for mild-to-moderate disease according to guidelines. Calcipotriol/betamethasone dipropionate (Cal/BD) [0.005%/0.05%] aerosol foam is indicated for psoriasis vulgaris treatment in adults. Cal/BD foam trials demonstrated improved efficacy and similar safety in this population. Psoriasis treatment is complicated by the broad range of disease presentation, variability, and therapeutic options; particularly decisions on transition from topical to non-biologic systemic treatment are difficult. Assessing comparative effectiveness of treatment options provides meaningful value to treatment decisions.

OBJECTIVE: To compare efficacy of Cal/BD foam individual patient data from pooled trials with efficacy of non-biologic systemic treatments based on aggregated patient characteristics and treatment outcomes.

METHODS: Individual data from 4 Cal/BD foam trials in 749 psoriasis patients were pooled to conduct matching-adjusted indirect comparisons. Literature review identified non-biologic systemic treatment trials where methods, populations, and outcomes align with Cal/BD foam trials. Of 3,090 screened publications, 4 studies of apremilast, methotrexate, acitretin, or Fumaric Acid Esters (FAE) were included.

RESULTS: After baseline matching, patients treated with 4 weeks of Cal/BD foam had greater Physician's Global Assessment 0/1 response compared to those treated with 16 weeks of apremilast (52.7% vs. 30.4%; P<0.001). Patients treated with Cal/BD foam had significantly greater Psoriasis Area and Severity Index (PASI) 75 response at Week 4 compared to 16 weeks of apremilast treatment (51.1% vs. 21.6%; P<0.001). Cal/BD foam patients demonstrated significantly greater PASI 75 response improvements at Week 4 versus 12 weeks of methotrexate (50.8% vs. 33.5%; P<0.001) or acitretin (50.9% vs. 31.7%; P=0.009), and comparable response to FAE (42.4% vs. 47.0%; P=0.451).

CONCLUSIONS: Despite recent treatment advances, unmet needs for psoriasis patients remain. Cal/BD foam offers improved efficacy in baseline matched psoriasis patients compared to apremilast, methotrexate, or acitretin, and comparable efficacy to FAE. This article is protected by copyright. All rights reserved.

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Approfondimenti

FonteJournal of the European Academy of Dermatology and Venereology
Titolo originaleCalcipotriol plus betamethasone dipropionate aerosol foam versus apremilast, methotrexate, acitretin, or fumaric acid esters for the treatment of plaque psoriasis: A matching-adjusted indirect comparison.
AutoriBewley A, Shear NH, Calzavara-Pinton PG, Hansen JB, Nyeland ME, Signorovitch J.
Link fonteLink articolo originale
Argomenti correlati psoriasi acido fumarico acitretina

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