Twice-weekly topical calcipotriene / betamethsone dipropionate foam as proactive management of plaque psoriasis increases time in remission and is well tolerated over 52 weeks (PSO-LONG trial)
Recommended Citation
Lebwohl M, Kircik L, Lacour JP, Liljedahl M, Lynde C, Mørch MH, Papp KA, Perrot JL, Gold LS, Takhar A, Thaçi D, Warren RB, and Wollenberg A. Twice-weekly topical calcipotriene / betamethasone dipropionate foam as proactive management of plaque psoriasis increases time in remission and is well tolerated over 52 weeks (PSO-LONG trial). J Am Acad Dermatol 2020.
Document Type
Article
Publication Date
9-17-2020
Publication Title
Journal of the American Academy of Dermatology
Abstract
BACKGROUND: Topical psoriasis treatment relies on a reactive, rather than long-term proactive, approach to disease relapse.
OBJECTIVE: Assess long-term efficacy and safety of proactive psoriasis management with twice-weekly calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) foam.
METHODS: Phase III trial (NCT02899962) included a 4-week open-label lead-in phase (Cal/BD foam once-daily) and 52-week, randomized, double-blind, maintenance phase. 545 patients achieved treatment success PGA 'clear'/'almost clear', ≥2-grade improvement from baseline) and were randomized to 'proactive' management (Cal/BD foam; n = 272) or 'reactive' management (vehicle foam; n = 273) twice-weekly, with rescue treatment of Cal/BD foam once-daily for 4 weeks upon relapse. Primary endpoint: time to first relapse (PGA ≥'mild').
RESULTS: 251 (46.1%) randomized patients completed the trial. Median time to first relapse: 56 days (proactive), 30 days (reactive). Patients in the proactive group had an additional 41 days in remission compared with the reactive group over 1 year (P < 0.001). Number of relapses per year of exposure: 3.1 (proactive), 4.8 (reactive). Cal/BD foam was well tolerated.
LIMITATIONS: Maintenance phase dropout rate (53.9%) was within the expected range but provides challenges in statistical analysis.
CONCLUSION: Long-term proactive management with Cal/BD foam demonstrated superior efficacy versus reactive management.
PubMed ID
32950546
ePublication
ePub ahead of print