Topical treatment of psoriasis with calcipotriol/betamethasone dipropionate cream in real-life clinical practice: expert opinion.

Abstract

Background: The fixed-dose combination of calcipotriol and betamethasone dipropionate (Cal/BDP) is an established topical psoriasis treatment. The cream formulation of Cal/BDP has been found effective and well-tolerated for the treatment of mild-to-moderate disease, with high levels of patient satisfaction. The aim of this consensus document is to guide optimal real-life use of Cal/BDP cream in patients with psoriasis.

Methods: Eight hospital-based dermatologists, with long-standing experience in psoriasis treatment, developed a consensus document on three topics (therapeutic protocols and schedules; high-impact areas; and treatment adherence) regarding the use of Cal/BDP cream in clinical practice. A modified Delphi process was used to achieve consensus among panel members. Statements with treatment recommendations, based on the experts' opinions and experience, as well as an analysis of relevant published data, were elaborated on and discussed during two meetings occurring two months apart. Full agreement among panel members was obtained after two online Delphi rounds.

Results: As seen in clinical trials, Cal/BDP cream monotherapy has proved beneficial in the treatment of mild to moderate plaque psoriasis. However, it can also be used as an adjunct to systemic/biologic drug treatment or as long-term maintenance therapy. Cal/BDP cream also plays an important role in the treatment of psoriasis on high-impact sites (including the scalp, peripheral facial areas, skin folds and palmoplantar areas) with treatment schedules varying according to disease severity and area involved. Due to its vehicle, treatment with Cal/BDP cream is associated with high levels of treatment convenience and patient acceptability, positively impacting adherence.

Conclusions: Cal/BDP cream can be used safely and effectively for the treatment of psoriasis in a range of clinical presentations. Its favorable cosmetic characteristics contribute to treatment success by enhancing patient adherence. Studies on the long-term use of Cal/BDP cream as a maintenance therapy are needed.