Fixed combination therapy with topical corticosteroids (TCS) and tazarotene may improve psoriasis signs and minimize posttreatment flare or rebound, according to a study published in the Journal of Drugs in Dermatology(JDD).
Psoriasis is a chronic, immune-mediated disease where topical corticosteroids (TCS) are the mainstay of treatment. Long-term safety remains a concern, limiting use, and posttreatment flare is common.
Topical tazarotene has been shown to be effective in controlling signs and symptoms of plaque psoriasis, with lower predicted posttreatment relapse rates than fluocinonide cream. However, low efficacy and skin-associated events, such as pruritus, burning, and erythema are common and can limit their use. Clinical studies have shown the added benefits of TCS as adjunctive therapy with tazarotene in the treatment of plaque psoriasis in terms of enhanced efficacy and tolerability.
David M and his associates conducted a study to investigate the maintenance of effect post-treatment with a once-daily application of halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in comparison with its active ingredients and vehicle in patients with moderate-to-severe plaque psoriasis.
The researchers conducted a multicenter, randomized, double-blind, vehicle-controlled Phase 2 study in moderate or severe psoriasis. The study included 212 participants randomized (2:2:2:1 ratio) to receive HP/TAZ, individual active ingredients, or vehicle, once-daily for 8 weeks with a 4-week posttreatment follow-up. Primary outcome included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score, and ‘clear’ or ‘almost clear’), and impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion.
Key study findings:
- At the end of the 4-week post-treatment period, 38.2% of patients who had been treated with HP/TAZ were treatment successes; compared with 21.0%, 12.8% and 6.9% of patients who had been treated with HP, TAZ or vehicle.
- HP/TAZ lotion was also superior in maintaining reductions in psoriasis signs of erythema, plaque elevation, and scaling at the target lesion.
- At the end of the 4-week post-treatment period, 49.1%, 54.5%, and 54.5% of patients, respectively, were treatment successes: compared with 38.7% ,48.4% and 48.4% of patients who had been treated with HP; 29.8%, 31.9% ,and 23.4% who had been treated with TAZ; and 13.8% ,20.7%, and 20.7% who had been treated with vehicle.
- Side effects were minimal and tended to resolve during the post-treatment period.
The study concluded that HP 0.01%/TAZ 0.045% lotion provides synergistic efficacy following 8 weeks’ therapy that is sustained after a 4-week post-treatment period.
For reference log on to http://jddonline.com/articles/dermatology/S1545961618P0723X
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