Reduction in the severity and extent of psoriasis vulgaris with Calcipotriol/Betamethasone Dipropionate ointment

Abstract

Research question: In adults with psoriasis vulgaris, is combined calcipotriol/betamethasone dipropionate ointment more effective than conventional topical agents in reducing the severity and extent of the disease? Purpose of the study: Although not life-threatening, the chronic skin disease, psoriasis, can still significantly impact the quality of life (QoL) and every aspect of the healthrelated quality of life (HRQoL) of those individuals involved. Topical therapies such as vitamin D3 analogues and corticosteroids play a significant role in mild-to-moderate psoriasis in reducing the severity and extent of the disease. The new topical therapy; calcipotriol/betamethasone dipropionate ointment, could potentially enhance the QoL and HRQoL of adult patients suffering from this condition by effectively reducing the severity and extent of psoriasis. Thus, the purpose of this dissertation was to appraise the literature for existing evidence evaluating the benefits of calcipotriol/betamethasone dipropionate ointment compared to calcipotriol ointment and betamethasone dipropionate ointment in adult patients suffering from psoriasis. Method: An in-depth search was implemented using various electronic databases such as PubMed, HyDi and EBSCO. Google scholar was also made use of to identify grey and unpublished articles. The articles’ references were also hand-searched for any other pertinent literature. The inclusion criteria consisted of articles of at least four weeks’ duration and involving patients aged eighteen and over with a stable clinical diagnosis of psoriasis vulgaris. There was no gender limitation however date filtering was between 2001-2016. This was done as the ointment under investigation was first introduced in 2001, therefore studies preceding that date were irrelevant. Articles had to be written in English as no translation facilities were provided. Only studies which assessed the calcipotriol/betamethasone dipropionate in the ointment formation were selected. In addition, studies that compared the calcipotriol/betamethasone dipropionate ointment to other conventional topical agents apart from calcipotriol ointment and betamethasone dipropionate ointment were also omitted. The final eight studies retrieved were then appraised using the PRISMA checklist, the CASP tools and the Cochrane Collaboration’s tool. Findings: Strong evidence supports the use of the calcipotriol/betamethasone dipropionate ointment over calcipotriol ointment and betamethasone dipropionate ointment in reducing the severity and extent of psoriasis vulgaris. Recommendations and implications for practice: There is the necessity for clinical care pathways and individualised approaches to improve patient care. Moreover, it is also clear that there is still need for further extensive research regarding psoriasis, both at a local and national level, to sustain EBP. Conclusion: Calcipotriol/betamethasone dipropionate ointment, when used once-daily, is more tolerable and effective, has a more abrupt onset of action and demonstrates less adverse events than either calcipotriol ointment or betamethasone dipropionate ointment used alone.