Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO-ABLE study

C Paul, L Stein Gold, F Cambazard, R E Kalb, D Lowson, B Bang, C E M Griffiths, C Paul, L Stein Gold, F Cambazard, R E Kalb, D Lowson, B Bang, C E M Griffiths

Abstract

Background: Fixed combination calcipotriol 50 μg/g (Cal) plus betamethasone 0.5 mg/g (BD) foam has been developed as a new treatment option for patients with psoriasis.

Methods: The randomized, parallel-group, investigator-blinded Phase III, 12-week PSO-ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel. Patients aged ≥18 years with mild-to-severe psoriasis were randomized 4:4:1:1 to once-daily Cal/BD foam, Cal/BD gel, foam vehicle or gel vehicle (NCT02132936). The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician's global assessment of disease severity (i.e. treatment success) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel. Secondary efficacy endpoints included: proportion of patients achieving at least a 75% reduction in modified psoriasis area and severity index (mPASI75), and time to treatment success (TTTS). Safety was monitored throughout.

Results: A total of 463 patients were randomized: Cal/BD foam (n = 185), Cal/BD gel (n = 188), foam vehicle (n = 47), gel vehicle (n = 43); overall completion rate was 90%. Cal/BD foam achieved higher treatment success rates (38% vs. 22%; P < 0.001) and mPASI75 (52% vs. 35%; P < 0.001) by week 4 than Cal/BD gel by week 8. Median TTTS with Cal/BD foam was 6 weeks; this could not be determined for Cal/BD gel as 50% treatment success was not achieved (P < 0.001). Adverse drug reactions were reported in 14 (7.6%) Cal/BD aerosol foam patients and 7 (3.7%) Cal/BD gel patients; all were single events except for itch with Cal/BD aerosol foam (n = 5; 2.7%) and worsening psoriasis with Cal/BD gel (n = 3; 1.6%).

Conclusion: Cal/BD aerosol foam showed significantly greater efficacy after 4 weeks, than 8 weeks of treatment with Cal/BD gel, with similar tolerability.

© 2016 European Academy of Dermatology and Venereology.

Figures

Figure 1
Figure 1
PSO‐ABLE study design. FU, follow‐up.
Figure 2
Figure 2
CONSORT diagram.
Figure 3
Figure 3
(a) Treatment success rates by visit (MI). (b) Time to treatment success, according to PGA (observed cases), in Cal/BD aerosol foam and gel groups. MI, multiple imputation.
Figure 4
Figure 4
(a) mPASI75 by visit in each treatment group (MI). (b) Time to mPASI75, according to PGA (observed cases). MI, multiple imputation.
Figure 5
Figure 5
‘Prefer current therapy’: Patient preferences at week 4 compared with previous topical therapies, grouped by previous topical therapy.

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Source: PubMed

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