Source: Diabetologia  |  Posted 8 years ago

Calcitriol ointment appears to be better tolerated and more effective than calcipotriol ointment for the treatment of plaque psoriasis involving facial, hairline, retroauricular and flexural areas.

Side effects of topical corticosteroids and the potential for irritation from vitamin D3 derivatives makes treating psoriasis difficult in sensitive areas, investigators explain. Previous studies have shown that calcitriol ointment, the naturally occurring and hormonally active form of vitamin D3, is safe and effective for psoriasis of the trunk and limbs.

The investigators, from multiple French and Bulgarian institutions including the Hopital de l'Archet 2 in Nice and the Bulgaria Military Medical Academy in Sofia, compared the safety and efficacy of calcitriol 3 micrograms/g ointment with calcipotriol 50 mcg/g ointment in a multi-centre, randomized, investigator-blinded study.

The two treatments were compared intra-individually in 75 subjects with mild to moderate chronic plaque psoriasis affecting sensitive areas.

A pair of bilateral and symmetrical lesions was selected from each area. Perilesional erythema, oedema and stinging and burning were all assessed. The investigators rated local tolerability and global improvement. Subjects were also asked to evaluate tolerability and efficacy and to report their preference for either treatment.

Results showed that both treatments cleared at least one target lesion in 28% of the subjects. The investigator-assessed global improvement was significantly greater for the lesions treated with calcitriol.

Perilesional erythema, perilesional oedema and stinging and burning were all significantly less severe with calcitriol compared with calcipotriol.

Reports of local tolerability by the subjects themselves significantly favoured calcitriol, and the subjects preferred calcitriol to calcipotriol ointment.