An investigator-initiated, double-blind, vehicle-controlled pilot study: Assessment for tachyphylaxis to topically occluded halobetasol 0.05% ointment in the treatment of psoriasis - 16/10/14
, Rita V. Linkner, MD c, Mayte Suárez-Fariñas, PhD b, Arie Ingber, MD d, Mark Lebwohl, MD cAbstract |
Background |
Topical corticosteroids are the most common first-line treatment for psoriasis. Tachyphylaxis, a decreased response to treatment with repetitive application of the drug, is a controversial phenomenon associated with topical corticosteroid treatment.
Objective |
We sought to prove or disprove tachyphylaxis to occluded halobetasol 0.05% versus vehicle.
Methods |
Patients with plaque psoriasis were recruited to this study. The study involved 3 phases (1, 2A, and 2B) with each phase being separated by a treatment vacation period. In phases 1 and 2A, 2 plaques were randomized to either halobetasol 0.05% or vehicle ointment application. In phase 2B, halobetasol 0.05% was applied to both. Target Lesion Severity Scale was used for clinical assessment.
Results |
Twenty patients were enrolled. No difference in time to clearance (P = .88) or time to recurrence (P = .92) of the treated plaques was found between phases 1 and 2A. Percentage of improvement was higher in phase 2A compared with phase 1 (89.4%, P < .05 vs 71%, P < .05), as a result of reduction of vehicle effect. In phase 2B, a greater improvement was found for previously corticosteroid-treated plaques.
Limitations |
Limitations are small sample size and 1 corticosteroid tested.
Conclusion |
No evidence of tachyphylaxis to the topical corticosteroid halobetasol 0.05% ointment treatment in patients with plaque psoriasis was found.
Le texte complet de cet article est disponible en PDF.Key words : compliance, corticosteroid, halobetasol 0.05%, psoriasis, tachyphylaxis, vehicle
Plan
| Funding sources: None. |
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| Disclosure: Dr Lebwohl was an investigator for Ranbaxy Laboratories Ltd during the years 2012 to 2013. Drs Czarnowicki, Linkner, Suárez-Fariñas, and Ingber have no conflicts of interest to declare. |
Vol 71 - N° 5
P. 954 - novembre 2014 Retour au numéro
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