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Topical Calcipotriol/betamethasone Dipropionate For Psoriasis Vulgaris: A Systematic Review

This document summarizes a systematic review of studies on the efficacy and safety of calcipotriol/betamethasone dipropionate for psoriasis vulgaris. The review found that calcipotriol/betamethasone dipropionate was more effective than either calcipotriol or betamethasone alone in reducing psoriasis symptoms. Once-daily application of calcipotriol/betamethasone dipropionate was as effective as twice-daily application with fewer adverse effects. The combination treatment provided effective relief of psoriasis vulgaris symptoms with only mild adverse effects.

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Rezkina Azizah Putri
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51 views

Topical Calcipotriol/betamethasone Dipropionate For Psoriasis Vulgaris: A Systematic Review

This document summarizes a systematic review of studies on the efficacy and safety of calcipotriol/betamethasone dipropionate for psoriasis vulgaris. The review found that calcipotriol/betamethasone dipropionate was more effective than either calcipotriol or betamethasone alone in reducing psoriasis symptoms. Once-daily application of calcipotriol/betamethasone dipropionate was as effective as twice-daily application with fewer adverse effects. The combination treatment provided effective relief of psoriasis vulgaris symptoms with only mild adverse effects.

Uploaded by

Rezkina Azizah Putri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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JOURNAL READING

Topical calcipotriol/betamethasone
dipropionate for
psoriasis vulgaris: A systematic review
Atika Lailana Qomarianty
1102014047

Pengampu:
dr. Vitalis Pribadi, M.Kes, Sp.KK
Kepaniteraan Klinik Ilmu Kesehatan Kulit dan Kelamin
Rumah Sakit Bhayangkara Tk. I R. Said Sukanto
Periode 16 April -18 Mei 2018
Fakultas Kedokteran Universitas YARSI
Journal Identity
• Topical calcipotriol/betamethasone dipropionate for psoriasis
Title vulgaris: A systematic review

• Ru Yan, Shibin Jiang, Yan Wu, Xing-Hua Gao, Hong-Duo Chen


Author

• Indian Journal of Dermatology, Venereology, and Leprology


Publisher

• 2016
year
INTRODUCTION
Most common:
Psoriasis Psoriasis
Vulgaris

Treatment for mild-moderate Combination of The combination can


psoriasis vulgaris is topically calcipotriol and reduce the side effect
agents (vit. D derivatives & betamethasone is often that was seen with
corticosteroids) used single topical agents

The aim: to examine the


efficacy and tolerability of
calcipotriol/betamethasone
dipropionate in the
treatment of psoriasis.
MATERIAL AND METHODS
Eligibility criteria Search strategy Outcome measures

• Randomized controlled trials • PubMed, China National • Primary outcome: percentage


involving psoriasis vulgaris Knowledge Infrastructure and reduction of the PASI score,
patients Cochrane library were the PASI score, and the
• Undergoing independently searched by proportion of patients who
calcipotriol/betamethasone two investigators achieved PASI 75 score.
dipropionate ointment/gel • All studies that matched the • Secondary outcome: the
therapy in the treatment search criteria were included proportion of “marked
group, without any other until April 2015 improvement or clearance”
simultaneous treatment by investigator assessment
• Undergoing calcipotriol or and occurrence of any
betamethasone ointment/gel adverse events.
therapy in the control group,
without any other
simultaneous treatment;
• Psoriasis on the body, with or
without scalp lesions
RESULTS (1)
RESULTS (2)

• 10 RCT involving 6590 participants with psoriasis vulgaris were


included
• 5 studies focused on Europeans and North Americans, 2 studies
focused on Asians, and the other 3 studies did not describe the
origin
• The mean age of patients: 40–50 years
• Men > women
• The duration of disease > 10 years in most of the studies
• The duration of treatment ranged 4-8 weeks
RESULTS (3)

Comparison of calcipotriol/betamethasone dipropionate (CBD)


with calcipotriol (CA)
• 10 trials: 4628 participants
• Frequency of application: 1x1 CBD vs 1x1 CA (3 studies), 1x1 CBD vs 2x1 CA
(5 studies), and 2x1 CBD vs 2x1 CA (2 studies)

• 4 weeks treatment duration (7 studies): almost all of studies show that


CBD group is more effective than CA group
• 8 weeks treatment duration (3 studies): all of studies show that CBD group
is more effective than CA group
RESULTS (4)
Comparison of calcipotriol/betamethasone dipropionate (CBD)
with betamethasone (BE)
• 5 trials: 3471 participants
• Frequency of application: 1x1 CBD vs 1x1 BE (3 studies) and 2x1 CBD vs
2x1 BE (2 studies)

• 4 weeks treatment duration (3 studies):


- Percentage reduction of PASI score = all of studies CBD > BE

• 8 weeks treatment duration (2 studies):


- Percentage reduction of PASI score = 2 studies CBD > BE (about 50% at
week 4). But at week 8, 1 study CBD > BE and the other study showed no
significant difference
- Patients who achieved a PASI 75 score = 1 study showed no significant
difference between groups at Week 4. But at week 8 more patients
achieved a PASI 75 score in CBD
RESULTS (5)

Comparison of calcipotriol/betamethasone dipropionate (CBD) once daily


With calcipotriol/betamethasone dipropionate (CBD) twice daily
• 384 participants
• 4 week trial
• Evaluated the percentage reduction of PASI score at week 1 & 4 and the
proportion of “marked improvement or clearance” by investigator
assesment at week 4  no statistically significant differences
RESULTS (6)
The most
common
adverse effect
noted in all
groups was
pruritus.

Adverse
effects
The percentage of patients who
withdrew from treatment due to
The proportion of patients
adverse effects was about 1% in the
reporting adverse effects to
once-daily CBD recipients, 1–10% in
CBD was significantly less than
CA recipients, 1–6% in BE recipients
those only on CA
and 7.5% in the twice-daily CBD
recipients
DISCUSSION

• This systematic review demonstrated that treatment with the two


compound formulation of calcipotriol/betamethasone dipropionate was
more effective than either agent used alone
• The once-daily use of calcipotriol/betamethasone dipropionate
application allows higher and more economical
• The CBD combination was found to be safer than calcipotriol. No
statistically significant differences existed between CBD and
betamethasone, or once-daily CBD and twice-daily CBD
CONCLUSION
Topical application of the two-
compound product
calcipotriol/betamethasone
dipropionate provides good
results for psoriasis vulgaris
with only mild adverse effects Limitation of studies that included in
this review:
- Inconsistent treatment protocols
- Various outcome measurements
- Relatively short treatment
duration
The optimal frequency of - Lack of long-term follow-up data
application is once daily

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