The Importance of the Formulation in the Treatment of Psoriasis: The Case of Calcipotriol/Betamethasone

Psoriasis is a prevalent chronic inflammatory skin disease impacting 1 to 3% of the general population in the Western World. Topical therapies are the most often used treatment in psoriasis, frequently as ancillary treatments to traditional systemic or biologic treatments in individuals with severe disease. Topical therapy with fixed-dose combination of a vitamin D analogue (calcipotriol (Cal)) and corticosteroid (betamethasone dipropionate (BD)) has been recommended as first-line topical treatment, and its efficacy and safety are supported by an increasing body of evidence. Ointment, gel, cream, and foam are the four distinct formulations of fixed-dose Cal/BD combination that have been authorized for the treatment of psoriasis. Several studies have compared these formulations in terms of efficacy, safety, and patients’ satisfaction. The objective of this study is to review all the comparative studies performed in patients with psoriasis of the Cal/BD foam formulation with respect to other topical treatments containing Cal and BD, either individually or in combination. The results of the studies published on this topic have shown that Cal/BD foam is more efficacious than both individual Cal/BD and Cal/BD ointment, gel, and cream. The safety profile, QoL, patient satisfaction, and cost-effectiveness were also higher for the Cal/BD foam formulation in different studies. Although more real-world clinical experience is required to validate the available data, Cal/BD foam may be the treatment of choice for both flare management and proactive maintenance treatment of psoriasis.