Itch relief in patients with psoriasis: effectiveness of calcipotriol plus betamethasone dipropionate foam

Background Itch is common in psoriasis, adversely affecting health?related quality of life (HRQoL) and sleep.

Objective We evaluated the efficacy of topical fixed?dose combination calcipotriol 50 ?g/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) on itch, itch?related sleep loss and HRQoL versus foam vehicle.

Methods We pooled data from three Phase II/III trials (NCT01536886/NCT01866163/NCT02132936) of Cal/BD foam versus foam vehicle in adults with mild–severe psoriasis. For itch?related analyses, patients with baseline itch VAS >40 (range 1–100) were analysed. Outcomes included: itch VAS reduction >40, ?70% improvement in itch (Itch70) or itch?related sleep loss, 75% improvement in modified PASI (excluding head) (mPASI75), and Dermatology Life Quality Index (DLQI) scores 0/1 through 4 weeks.

Results Of 837 patients, 800 had baseline itch VAS >0 (Cal/BD foam, n=610; foam vehicle, n=190); 484 had baseline itch VAS >40. There was no correlation between itch VAS score and mPASI at baseline (R2 = 0.021). In patients with baseline itch VAS >40, more patients achieved itch VAS reduction >40 in the active versus vehicle group from Day 5 onwards (Day 5: 57.5 vs 40.2% [P<0.05]; Week 4: 83.0 vs 45.8% [P<0.001]). More Cal/BD foam4?treated patients achieved Itch70 at Day 3 (34.2 vs 22.5%; P<0.05) through to Week 4 (79.3 vs 38.1%; P<0.001). In patients with baseline itch VAS >40 and sleep loss >20, improvements in itch?related sleep loss occurred at Week 1 and continued through 4 weeks. Itch?related improvements occurred before improvements in mPASI75. There were significant differences in the proportion of Cal/BD?foam? versus foam?vehicle?treated patients with baseline DLQI >10 (N=172 vs N=50) achieving DLQI ?1 (25.0% vs 4.0%; P=0.001) and DLQI 0 (17.4% vs 2.0%; P=0.006) at Week 4.

Conclusion Compared with foam vehicle, Cal/BD foam offers more rapid and effective itch relief, with associated significant improvements in sleep and DLQI.