Comparative Clinical Assessment of Effectiveness and Safety of Calcitriol and Calcipotriol in Mild Plaque Psoriasis

Introduction: Psoriasis is defined as chronic disease of the skin which is treated by topical drugs, systemic drugs or phototherapy depending on its severity. Vitamin D analogues are also commonly used in psoriasis, and its combination with topical corticosteroids (TCS) has shown to have synergistic action leading to more effective control of symptoms of psoriasis as well as decrement in adverse events like skin atrophy associated with prolonged TCS therapy. The present study was undertaken in pursuit of comparative assessment of effectiveness and safety of calcitriol and calcipotriol in patients diagnosed with mild psoriasis. Material and methods: This was a multicentre, retrospective data analysis and comparison between calcitriol and calcipotriol ointment done at 129 dermatology clinics across India after obtaining ethics committee approval. The data charts were identified by generating a list of all patients who were prescribed clobetasol and calcitriol as fixed dose combination for 2 weeks followed by either calcitriol (group 1) or calcipotriol (group 2) for 4 weeks at all clinics, using medical record database. Results: Out of 1076 records, a total of 630 patients met inclusion criteria. Improvement in symptoms was seen in all patients. Improvement in Physician Global assessment Score (PGAS) and Psoriasis Area and Severity Score (PASI) was seen consistently throughout the treatment period in both the groups, but greater improvement was seen in calcitriol group as compared to calcipotriol group at day 42 (p<0.05). Overall, the adverse effects in calcitriol group were less as compared to calcipotriol group. Conclusion: The findings of the present study suggests that calcitriol offers better effectiveness and safety over calcipotriol in maintenance phase of treatment of mild to moderate psoriasis and also it can serve as better option to maximise the therapeutic effect of topical corticosteroid as a fixed dose combination in acute phase of treatment.