Patient-Reported Satisfaction With the Fixed Combination Calcipotriene/Betamethasone Dipropionate Foam for Plaque Psoriasis
August 2018 | Volume 17 | Issue 8 | Original Article | 880 | Copyright © August 2018
Joe Gorelick MSN FNP-BC,a Wendy Cantrell DNP CRNP,b Kristine Kucera PA-C MPAS DHS,c Karen A. Veverka PhD,d Kara Gooding MMS PA-Ce
aCalifornia Skin Institute, San Jose, CA bUAB Department of Dermatology, Birmingham, AL cNorth Texas Dermatology, Richardson, TX; UT Southwestern Physician Assistant Program, Dallas TX; UNT Health Science Center, Ft. Worth, TX dMedical Strategy and Scientific Affairs, LEO Pharma Inc., Madison, NJ eCenter for Dermatology & Plastic Surgery, Scottsdale, AZ
Abstract
Psoriasis is a chronic, immune-mediated inflammatory disease characterized by localized scaling and plaques associated with itching and pain. In some cases, topical therapies are effective to treat mild to moderate psoriasis. Topical agents can be used concomitantly with other treatments for moderate and severe or treatment-resistant psoriasis. Patient adherence to medication regimens remains a major challenge in therapy, especially with topical agents, for which adherence can be affected by the amount of time needed for application, the treatment formulation, cost, and cosmetic characteristics. This study was conducted to obtain feedback from patients clinically diagnosed with psoriasis regarding their satisfaction following once-daily topical application of the fixed combination calcipotriene (Cal) 0.005% and betamethasone dipropionate (BD) 0.064% foam for 15 days. Patients completed a 13-question online survey. In this community-based setting of patients with mild to severe psoriasis, patients were satisfied with Cal/BD foam after 15 days of use; 94% were satisfied or highly satisfied with symptom relief. Most of the patients (88%) were satisfied with how Cal/BD foam felt on their skin. After 15 days of use, 94% of patients would recommend Cal/BD foam to other patients with psoriasis, with 73% being very likely to do so. These findings may have important implications for optimizing medical decision-making, treatment adherence, and health outcomes in clinical practice. The cosmetic acceptability of the fixed combination Cal/BD foam formulation and patient satisfaction may make Cal/BD aerosol foam a more acceptable topical treatment than other currently available vehicles for patients with plaque psoriasis.
J Drugs Dermatol. 2018;17(8):880-884.
INTRODUCTION
Psoriasis is a chronic, immune-mediated inflammatory disease that affects >3% of adults aged ≥20 years in the United States.1,2 Primarily characterized by localized scaling and plaques that can cause itching and pain, plaque psoriasis is the most common morphology and accounts for 80%–90% of individuals with psoriasis.1,3 Most patients with psoriasis have mild disease that can be effectively treated with topical therapy. For patients with severe psoriasis, topical treatments can be used concomitantly with ultraviolet light therapy or systemic medications.4,5 Recent advances in topical medication vehicle delivery systems may improve efficacy and patient acceptance.4,6,7 Patient preference and disease characteristics and location are important factors to consider when selecting a topical agent and delivery method/vehicle (ie, creams, gels, foams, tape, shampoos, ointments, sprays, lotions, solutions).4Despite the wide variety of available topical treatment options, >50% of patients report being dissatisfied with their psoriasis treatment.2 Treatment adherence remains a major challenge in topical therapy.8-10 Low adherence rates to topical therapeutic regimens have been attributed to the amount of time needed for application, cost, and the type of treatment formulation, which affects the cosmetic characteristics or messiness.8-10 Patient dissatisfaction with traditional topical treatments has led to the development of new vehicle formulations that may improve treatment outcomes and patient satisfaction. A fixed combination foam containing a synthetic vitamin D3 analog, calcipotriene (Cal) 0.005%, and a potent synthetic corticosteroid, betamethasone dipropionate (BD) 0.064%, is approved for the topical treatment of plaque psoriasis.11 The combination of Cal and BD effectively reduces both inflammation and abnormal keratinization associated with plaque psoriasis.4 Cal/BD foam has been widely established as an effective treatment for plaque psoriasis4 and was demonstrated clinically to be more effective than the individual
