Calcipotriene–Betamethasone Dipropionate Topical Suspension in the Management of Psoriasis: A Status Report on Available Data With an Overview of Practical Clinical Application
Psoriasis is a multifactorial process associated with immunologic dysregulation. Chronic plaque psoriasis (PP) is the most common clinical presentation. Plaque psoriasis is characteristically a chronic disease associated with periods of persistence and episodes of flaring; therefore, intermittent use of topical corticosteroid (TC) therapy along with concurrent or sequential use of a nonsteroidal topical agent is commonly employed to achieve and sustain control of the disorder. Calcipotriene 0.005%–betamethasone dipropionate 0.064% topical suspension (C/Bd-TS) is a rational option for the treatment of PP in patients with localized disease or in patients treated systemically or with phototherapy for more extensive disease who exhibit persistence or recurrence of scattered areas of PP. This article provides a review of a patented topical suspension combination formulation of C/Bd-TS, including formulation characteristics, perspectives on modes of action, outcomes from pivotal trials, and efficacy and safety data reported from additional studies.
Practice Points
- Calcipotriene 0.005%–betamethasone dipropionate 0.064% topical suspension (C/Bd-TS) applied once daily has been shown in multiple studies to be effective, well tolerated, and safe for the treatment of plaque psoriasis (PP) involving the scalp and/or other body sites such as the trunk and extremities. Studies have included all severities of PP, with both investigator and subject assessments shown to be favorable overall.
- Most studies were completed in adults over a duration of 8 weeks; however, clinical trials also have been performed with C/Bd-TS in adults treated for up to 52 weeks for scalp psoriasis, in a subgroup of Hispanic/Latino and black/African American adult patients with scalp psoriasis, and in adolescents with scalp psoriasis.
- Studies evaluating application of C/Bd-TS once daily for PP affecting nonscalp sites have primarily involved use on the trunk and extremities.
- The adaptability for scalp and body application allows for use in many cases of a single topical product without needing to prescribe a second leave-on medication specifically for use on the scalp.
What practical recommendations can be made regarding the use of C/Bd-TS for PP?
Calcipotriene 0.005%–Bd 0.064% topical suspension applied once daily provides a formulation that allows for treatment of PP involving both the scalp and body using a single product, which provides an element of convenience and is likely to enhance compliance and reduce costs compared with the use of 2 separate products. The efficacy and safety of C/Bd-TS has been well established in several studies,16-23,37 including a 52-week trial in patients with scalp psoriasis.36 The combination of calcipotriene and Bd appears to favorably address the pathophysiologic pathways involved in psoriasis.29,30 Calcipotriene 0.005%–Bd 0.064% topical suspension is a rational option for the treatment of PP in patients with localized disease or in patients treated systemically or with phototherapy for more extensive disease who exhibit persistence or recurrence of scattered areas of PP.6-9,14,15 Appropriate use of C/Bd-TS is likely to achieve favorable efficacy with a low risk of tolerability reactions and a very low risk of major adverse drug reactions.16-23,36-38
