INTRODUCTION
Topical treatments are often used both as first-line monotherapy for mild plaque psoriasis and as adjunct therapy for patients with more severe disease.1-3 Psoriasis is a chronic condition, and patients may require long-term maintenance and retreatment for flares. However, an unappealing appearance and difficulties in application are barriers to adherence to prescribed topical therapies.4 In some real-world clinical settings, adherence to topical treatments has been estimated to be lower than 50%.5 In a 2017 systematic review that included studies of patients with psoriasis of varying severity using common topicals (eg, corticosteroids, vitamin D analogues, tar), patient satisfaction ranged from 12% to 52%, and patient-reported adherence ranged from 12% to 72%.6 Among the topicals used by patients in this review, corticosteroids were the most commonly used (up to 79%), suggesting the importance of enhancing adherence to this class of topicals.5 In a 2018 systematic review (including 26 studies comprising 17,472 patients with psoriasis), satisfaction with current treatments was low, and patients using biologics had a higher rate of satisfaction compared with those using topicals and other treatments. This highlights the unmet need that must be addressed for patients using topical psoriasis treatments.
When patients encounter challenges using topicals as prescribed, they may use them irregularly, which limits their effectiveness, or even stop treatment abruptly.7 For patients using topical steroids, this sudden, premature cessation of treatment can cause a rebound effect, with a possible increase in severity or area involved in psoriasis.8 Irregular use can create a frustrating cycle of inadequate treatment and retreatment, with disruptive signs and symptoms of psoriasis persisting. In the context of this treatment landscape, there is a need for treatment options that balance long-term safety and efficacy with patient preferences regarding topical formulations. The development of new topical vehicles and treatment guidelines should emphasize attributes that are highly valued by patients. On an individual level, it is
When patients encounter challenges using topicals as prescribed, they may use them irregularly, which limits their effectiveness, or even stop treatment abruptly.7 For patients using topical steroids, this sudden, premature cessation of treatment can cause a rebound effect, with a possible increase in severity or area involved in psoriasis.8 Irregular use can create a frustrating cycle of inadequate treatment and retreatment, with disruptive signs and symptoms of psoriasis persisting. In the context of this treatment landscape, there is a need for treatment options that balance long-term safety and efficacy with patient preferences regarding topical formulations. The development of new topical vehicles and treatment guidelines should emphasize attributes that are highly valued by patients. On an individual level, it is
