Topical combination therapy with vitamin D<sub>3</sub> and corticosteroid ointment for palmoplantar pustulosis: A prospective, randomized, left-right comparison study

Muro, Mayuko; Kawakami, Hiroshi; Matsumoto, Yuka; Abe, Namiko; Tsuboi, Ryoji; Okubo, Yukari

doi:10.3109/09546634.2015.1052036

Cited by 17 publications

(20 citation statements)

References 8 publications

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“…Several studies of topical treatments in PPP have been published. Two studies showed the efficacy of topical maxacalcitol (22-oxacacitriol, vitamin D 3 analog) [72,73]. Umezawa et al [73] conducted a clinical trial and stated that 87 of 94 (92.55%) patients reported improvement (marked, moderate, or mild) in skin lesions after treatment with maxacalcitol twice daily for 8 weeks, compared with 70 of 93 (75.25%) of those receiving placebo; p < 0.0001.…”

Section: Topical Treatmentmentioning

confidence: 99%

“…Umezawa et al [73] conducted a clinical trial and stated that 87 of 94 (92.55%) patients reported improvement (marked, moderate, or mild) in skin lesions after treatment with maxacalcitol twice daily for 8 weeks, compared with 70 of 93 (75.25%) of those receiving placebo; p < 0.0001. Muro et al [72] found that combination therapy with maxacalcitol ointment and betamethasone butyrate propionate ointment was more effective than monotherapy with betamethasone butyrate propionate. A case report described improvement of PPP with crisaborole (a topical phosphodiesterase-4 [PDE-4] inhibitor) [74], and a case report of the use of tacrolimus 1% ointment twice daily has also been published [75].…”

Section: Topical Treatmentmentioning

confidence: 99%

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Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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Palmoplantar pustulosis (PPP) is a chronic, recurrent skin disease belonging to the spectrum of psoriasis. It is characterized by an eruption of sterile pustules on the palms and soles. Recent studies in PPP have focused on genetic differences between pustular phenotypes and the role of the innate immunological system and the microbiome in the etiopathogenesis of the disease. Mutations in IL36RN (a major predisposing factor for generalized pustular psoriasis) were found in selected patients with PPP and were associated with earlier disease onset. Studies have shown that the interleukin (IL)-17 and IL-36 pathways might be involved in the pathogenesis of PPP. A microbiome has been demonstrated in the vesicopustules of PPP, and an abundance of Staphylococcus appears to be increased by smoking. Improved understanding of the underlying etiopathogenesis of PPP has led to advances in treatment options, and targeted therapies for PPP have been evaluated or are under evaluation against more than 12 molecules in ongoing clinical trials.

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Section: Topical Treatmentmentioning

confidence: 99%

Section: Topical Treatmentmentioning

confidence: 99%

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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“…One study showed that vitamin D3 lowers mortality in the severe vitamin D deficiency subgroup of sepsis patients ( 134 ), but these results could not be confirmed in a recent trial ( 135 ). Interestingly, in inflammatory disorders such as psoriasis and palmoplantar pustulosis, combining GCs with vitamin D3 appears to be more effective than GC or vitamin D3 monotherapy as these two agents work synergistically ( 136 , 137 ). Whether this is also the case for sepsis remains to be studied.…”

Section: A Therapeutic Role For Exogenous Gcs In Sepsis?mentioning

confidence: 99%

Glucocorticoids in Sepsis: To Be or Not to Be

Vandewalle

Libert

2020

Front. Immunol.

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“…Systemic therapies for PPP, such as retinoids, cyclosporine, and methotrexate, lack controlled studies evaluating defined treatment regimens. 7,[14][15][16][17][18] Among biologic therapies for PPP, variable results have been reported with tumor necrosis factor α (TNF-α) inhibitors (etanercept, adalimumab) and ustekinumab, a monoclonal antibody that targets interleukin 12 (IL-12) and IL-23; thus, more effective and reliable therapies are desirable. [19][20][21][22] Recently, secukinumab, an anti-IL-17A antibody, showed pronounced efficacy in palmoplantar psoriasis.…”

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confidence: 99%

Efficacy and Safety of Guselkumab, an Anti–interleukin 23 Monoclonal Antibody, for Palmoplantar Pustulosis

et al. 2018

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IMPORTANCE Palmoplantar pustulosis (PPP) is a recalcitrant skin disease with no biologics currently approved for treatment. The involvement of interleukin 23 (IL-23) and cytokines of the type 17 helper T cell lineage in the pathogenesis of PPP has been recently postulated. OBJECTIVE To evaluate the efficacy and safety of guselkumab, an anti-IL-23 monoclonal antibody, in Japanese patients with PPP. DESIGN, SETTING, AND PARTICIPANTS This double-blind, randomized, placebo-controlled, parallel-group, 24-week trial was conducted between May 14, 2013, and September 27, 2014, at 11 centers in Japan. Participants were patients with moderate to severe PPP that did not respond adequately to conventional treatments. INTERVENTIONS Patients were randomized 1:1 to receive guselkumab, 200 mg, by subcutaneous injection or matching placebo at weeks 0 and 4. MAIN OUTCOMES AND MEASURES Changes in total scores of skin-related outcomes from baseline at the end of week 16 (primary clinical cutoff) and through week 24 were measured. Serum biomarker analyses were performed at baseline, week 4, and week 16, and safety was monitored through week 24. RESULTS Of 49 randomized patients (35 [71%] women; median [range] age, 52 [28-77] years), 41 completed the study at week 24. Mean (SD) PPP severity index total scores (primary end point) improved significantly from baseline in guselkumab-treated patients (−3.3 [2.43]) vs placebo (−1.8 [2.09]) (least squares mean difference, −1.5; 95% CI,-2.9 to-0.2; P = .03). At week 16, PPP area and severity index scores (least squares mean difference, −5.65; 95% CI, −9.80 to −1.50; P = .009) and proportion of patients achieving 50% reduction in these scores (difference in proportion, 39.2; 95% CI, 14.0-64.3; P = .009) improved significantly. A numerically higher proportion of patients had a physician's global assessment score of 1 or less in the guselkumab group vs placebo. Improvement in efficacy scores was maintained through week 24 in the guselkumab group. Significant reductions from baseline in serum IL-17A and IL-17F cytokine levels were observed at weeks 4 and 16. Frequency of treatment-emergent adverse events was comparable between the guselkumab group (19 of 25 patients [76%]) and the placebo group (18 of 24 patients [75%]). Frequent adverse effects included nasopharyngitis (14 patients [29%]), headache (3 patients [6%]), contact dermatitis (3 patients [6%]), and injection site erythema (3 patients [6%]). No major safety concerns emerged during the study. CONCLUSIONS AND RELEVANCE Targeting IL-23 and its associated immune cascade with guselkumab may be a safe and useful therapeutic option for treatment of PPP.

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Topical combination therapy with vitamin D₃ and corticosteroid ointment for palmoplantar pustulosis: A prospective, randomized, left-right comparison study

Abstract: This combination regimen demonstrated that not only topical corticosteroids, but also topical vitamin D3 ointment, is useful for the treatment of PPP.

Cited by 17 publications

References 8 publications

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Glucocorticoids in Sepsis: To Be or Not to Be

Efficacy and Safety of Guselkumab, an Anti–interleukin 23 Monoclonal Antibody, for Palmoplantar Pustulosis

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Topical combination therapy with vitamin D3 and corticosteroid ointment for palmoplantar pustulosis: A prospective, randomized, left-right comparison study

Abstract: This combination regimen demonstrated that not only topical corticosteroids, but also topical vitamin D3 ointment, is useful for the treatment of PPP.

Cited by 17 publications

References 8 publications

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Glucocorticoids in Sepsis: To Be or Not to Be

Efficacy and Safety of Guselkumab, an Anti–interleukin 23 Monoclonal Antibody, for Palmoplantar Pustulosis

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Product

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Topical combination therapy with vitamin D₃ and corticosteroid ointment for palmoplantar pustulosis: A prospective, randomized, left-right comparison study