Clinical trial of the efficacy and safety of oral etretinate withcalcipotriol cream compared with etretinate alone inmoderate-severe psoriasis

Background The aim of this clinical trial was to assess the efficacy and safety of calcipotriol cream associated with oraletretinate compared with etretinate alone in the treatment of moderate-severe psoriasis.Methods This controlled multicenter trial, within patients (hemiparts), enrolled 86 in- or out-patients (62 males, 24 females),mean (LSD) age 57.1 5 14.2 years, with psoriasis vulgaris on both sides of the body, and mean (LSE) baseline PASI score(Psoriasis Area and Severity Index) 30.7 ? 0.9. All patients took oral etretinate 50 mg/day and applied calcipotriol cream (50kg/g) on one half of their body twice a day. Treatment was continued for 9 weeks, and patients were seen every 3 weeks.Results At the end of the first 3 weeks the PASI score indicated a significant clinical difference between the two sides of thebody (P < 0,001, ANOVA), with a reduction of 50.7% in the score for the calcipotriol-treated half, compared with a 39%reduction for the untreated half. By the 9th week of treatment the PASI score was 81.4% lower on the treated half, and 70.3% onthe untreated side (P < 0.001, ANOVA).Conclusions These findings suggest that patients with moderate-severe psoriasis might benefit from treatment with etretinateplus calcipotriol, with the aim of achieving a faster response and an overall smaller total dose of etretinate.