Improvement of psoriasis by a topical vitamin D3 analogue (MC 903) in a double-blind study

Kragballe, Knud; Beck, Henning; Søgaard, H

doi:10.1111/j.1365-2133.1988.tb03204.x

Cited by 205 publications

(93 citation statements)

References 19 publications

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“…A beneficial effect of the combination of calcipotriol and phototherapy was first shown by Kragballe et al [5], comparing calcipotriol alone with calcipotriol + UVB in a right-left-side study design. The difference in favour of the combination as compared with calcipotriol alone was, however, not significant, probably due to the low number of patients (20 patients) studied.…”

Section: Discussionmentioning

confidence: 99%

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Topical Calcipotriol Combined with Phototherapy for Psoriasis

Molin

1999

Dermatology

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Background: Calcipotrial has a well-documented effect in the treatment of psoriasis. Objective: To confirm the beneficial effect of the combination of calcipotriol and UVB and to demonstrate that the combination is safe and well tolerated. Methods: Data from two randomized right/left studies were analysed. Patients included in the studies had chronic stable plaque-type psoriasis with symmetrical lesions on the arms, the legs and/or the trunk. In one study, 101 patients were treated with calcipotriol on one side and calcipotriol + UVB on the other side of the body (open study). In the other study, 77 patients were treated with calcipotriol + UVB on one side and vehicle + UVB on the other side of the body (double-blind study). Calcipotriol ointment, 50 μg/g, was applied twice daily and UVB 3 times weekly for 8 weeks. UVB was increased from 0.7 MED before treatment in rapid steps up to the erythema threshold. Result: In both treatment series the therapeutic effect of the combination of calcipotriol and UVB was enhanced as compared to calcipotriol alone and UVB alone. In the first series there was a significant reduction of the psoriasis area and severity index (PASI) with the combination after 2 weeks as compared to calcipotriol alone. At the end of treatment significantly more sides were cleared after calcipotriol + UVB than after calcipotriol alone. In the other series there was a significantly faster onset of improvement on the sides treated with calcipotriol + UVB than on those treated with vehicle + UVB. After 2 weeks there was a significant difference in PASI in favour of calcipotriol + UVB. At the end of treatment, however, there was no difference between the treatments. There was a similar adverse event profile with either treatment. The addition of UVB to calcipotriol did not alter the tolerability or safety of topically applied calcipotriol. Conclusions: The result indicates a beneficial effect of combining calcipotriol and phototherapy. The findings are compared to other published studies.

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Section: Discussionmentioning

confidence: 99%

“…epidermal hyperproliferation, epidermal cell differentiation and cutaneous inflammation [2, 3, 4]. Clinical experience with calcipotriol has shown its efficacy in the treatment of psoriasis [5, 6]. A previous study indicated that the effect of calcipotriol in psoriasis was improved by the addition of UVB [7].…”

Section: Introductionmentioning

confidence: 99%

Topical Calcipotriol Combined with Phototherapy for Psoriasis

Molin

1999

Dermatology

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“…Immunohistochemical stainings have shown that corticosteroids reduce both the epidermal hyperproliferation and the dermal inflammatory infiltrate, both effects being detectable within 2–3 weeks [12, 13], whereas the expression of keratin 10 (terminal differentiation) is unchanged [12]. Vitamin D 3 analogues result in a decreased epidermal proliferation, increased epidermal differentiation and a decreased dermal inflammatory infiltrate [14, 15]. For vitamin D analogues, it takes about 6–8 weeks before the effect on dermal lymphocyte infiltration can be detected, and it has been suggested that vitamin D 3 analogues are less effective in reducing the number of inflammatory cells than in modifying keratinocyte proliferation and differentiation [16, 17].…”

Section: Introductionmentioning

confidence: 99%

Decrease in Enkephalin Levels in Psoriatic Lesions after Calcipotriol and Mometasone Furoate Treatment

Nissen

Avrach²,

Hansen³

et al. 1999

Dermatology

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Background: Enkephalins are opioid peptides that can modulate immune responses and inflammatory processes. Furthermore, they inhibit keratinocyte proliferation/differentiation in vitro. Previously, we have shown that enkephalins are present in increased amounts in lesional psoriasis. Objective: To determine the effect of topical treatment with the vitamin D analogue calcipotriol and the corticosteroid mometasone furoate on the level of methionine-enkephalin (enk) in psoriatic lesions. Methods: Twelve psoriatic patients were treated with calcipotriol and mometasone furoate for 14 days without or with hydrocolloid occlusion. Keratome biopsies were obtained from treated and untreated skin, and the extracted enk was quantified by radioimmunoassay. Furthermore, punch biopsies were obtained for immunohistochemical analysis. Results: Clinically, both calcipotriol and mometasone furoate improved psoriasis to the same degree, the effects being more pronounced after occlusion. Histologically, treatment with mometasone furoate without occlusion decreased both the epidermal thickness/parakeratosis and the number of dermal immunocompetent cells (CD3- and CD68-positive cells). In contrast, treatment with calcipotriol without occlusion reduced the epidermal thickness and the degree of parakeratosis but decreased the number of CD3- and CD68-positive cells only slightly. The mean enk level was decreased by 26 and 86% by calcipotriol without and with occlusion and by 16 and 63% by mometasone furoate without and with occlusion, respectively. The decreases in the enk levels corresponded to the degree of clinical improvement but not to the histological changes. Conclusion: The increased levels of enk in psoriatic lesions are reduced in parallel with the clinical improvement induced by a topical vitamin D analogue and a corticosteroid. Because enkephalins can modulate epidermal differentiation and inflammatory processes, the findings indicate that enkephalins may play a role in the pathogenesis of psoriasis.

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“…Ennek magyarázata lehet, hogy az aktív Dvitamin gyorsítja a keratocyták differenciálódá sát és gátolja a proliferációjukat [47,48,49], ugyan akkor előnyösen hat a betegség kialakulásában szerepet játszó immunfolyamatokra is [50]. Napjainkban a be tegség egyik alapkezelése az ideális Dvitaminszint biztosítása mellett alkalmazott kalcitriol vagy a kevéssé hypercalcaemizáló Dvitaminanalógok (kalcipotriol, ta kalcitol, maxakalcitol) lokális használata [51,52,53,54,55,56,57].…”

Section: D-vitamin-hiány Hatása a Bőrre Dr Wikonkál Norbertunclassified

Állásfoglalás

et al. 2012

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A Dvitamin anyagcseréje egyedülálló az emberi szer vezetben. Hatása szerteágazó, szinte minden szervrend szerben érvényesül. Hiánya az egyik legnagyobb egész ségügyi probléma a civilizált világban. A probléma megoldása széles körű összefogást sürget. Ezt felis merve, a Dvitaminhiány következményeivel küzdő legnagyobb magyarországi orvostársaságok közös kon szenzust dolgoztak ki a Dvitaminhiány jelentőségéről, felismerési lehetőségeiről, a prevenció és a kezelés java solt módjairól. A társaságok szakmai irányelvei mellett ennek a konszenzusnak az eredménye iránymutatást ad a gyakorló orvosoknak a Dvitaminhiány megelőzésé hez és kezeléséhez. Emellett szeretné ráirányítani a szak mai döntéshozók és a laikus közönség fi gyelmét a prob léma fontosságára.

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Improvement of psoriasis by a topical vitamin D3 analogue (MC 903) in a double-blind study

Cited by 205 publications

References 19 publications

Topical Calcipotriol Combined with Phototherapy for Psoriasis

Topical Calcipotriol Combined with Phototherapy for Psoriasis

Decrease in Enkephalin Levels in Psoriatic Lesions after Calcipotriol and Mometasone Furoate Treatment

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