Calcitriol 3 µg g−1ointment in combination with ultraviolet B phototherapy for the treatment of plaque psoriasis: results of a comparative study

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Abstract
Background Combinations of topical treatments and ultraviolet (UV) B phototherapy for plaque psoriasis may be more beneficial than either type of treatment used alone. Objectives To determine the efficacy of calcitriol 3 µg g−1 ointment in combination with UVB phototherapy in treating plaque psoriasis. Methods Calcitriol ointment with UVB was compared with vehicle plus UVB in a randomized, double‐blind study in 104 patients. Results Mean global improvement scores for both groups increased over the 8‐week study period; there was a statistically significant difference (P < 0·05) in favour of the calcitriol/UVB combination from week 1. At end‐point, 45% of the calcitriol/UVB group showed considerable improvement or clearing of psoriasis, compared with 21% of the control group. The superiority of calcitriol plus UVB was also reflected in the global severity and Psoriasis Area and Severity Index (PASI) scores; at end‐point the mean percentage decrease in PASI score was 65% for the calcitriol/UVB group and 43% for vehicle/UVB (P = 0·0014). The incidence of skin‐related adverse events was low (< 12%) and similar in the two treatment groups. No clinically significant changes in blood chemistry, in particular calcium levels, occurred. The greater efficacy of combined calcitriol and phototherapy allowed a 34% decrease in total UVB exposure. Conclusions Calcitriol 3 µg g−1 ointment and UVB phototherapy in combination provides a promising therapy for managing chronic plaque psoriasis.