Patient Preference for Calcipotriene and Betamethasone Dipropionate Cream Versus Foam for the Topical Treatment of Psoriasis: A Pilot Study

March 2023 | Volume 22 | Issue 3 | 271 | Copyright © March 2023


Published online February 21, 2023

Charles Kircik a, Leon H. Kircik MDb

aStony Brook University SUNY, Stony Brook, NY
bIcahn School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY; Skin Sciences, PLLC, Louisville, KY

Abstract
Background: The well-established sequential use of topical calcipotriene and topical betamethasone dipropionate in combination has been shown to provide greater benefit than either monotherapy. A newer topical fixed combination formulation of calcipotriene 0.005% and betamethasone dipropionate 0.064% in a cream base (Cal/BD cream) is effective with high patient ratings for convenience and tolerability. The current study compares patient satisfaction between Cal/BD foam and Cal/BD cream formulations.
Study Design and Patient Demographics: This is a single-use, split body, open label study involving 20 subjects. Ten subjects additionally had scalp psoriasis. Study treatments were applied by the investigator in a randomized manner and patients completed questionnaires to assess treatment preferences.
Findings: Both Cal/BD formulations provided rapid and significant improvement in symptoms of pruritus, stinging, burning, and pain; with no statistically significant difference in response between the 2 treatments. Overall, Cal/BD cream outperformed Cal/BD foam on several key measures for vehicle features and patient satisfaction. For non-scalp application, 55% of subjects preferred Cal/BD cream over Cal/BD foam. For the scalp, 60% of subjects preferred Cal/BD cream over Cal/BD foam. No adverse events were reported during the study.
Conclusion: Results of this current study indicate high levels of patient satisfaction with Cal/BD cream and a preference for the cream base over foam for the treatment of body and scalp psoriasis.
 
J Drugs Dermatol. 2023;22(3): doi:10.36849/JDD.7165

Citation: Kircik C, Kircik LH. Patient preference for calcipotriene and betamethasone dipropionate cream versus foam for the topical treatment of psoriasis: A pilot study. J Drugs Dermatol. 2023;22(3):271-273. doi:10.36849/JDD.7165

INTRODUCTION

The sequential use of the topical vitamin D analog, calcipotriene, and the topical corticosteroid, betamethasone dipropionate, is well established for the treatment of psoriasis; and the 2 agents used in combination have been shown to provide greater benefit than either monotherapy.1,2,3

Fixed combinations of calcipotriene and betamethasone dipropionate (Cal/BD) are available in ointment, foam, and topical suspension formulations. A Cal/BD aerosol foam formulation (Enstilar, LEO Pharma) is well established in the market. In clinical trials for psoriasis, Cal/BD aerosol foam was significantly more effective than either Cal/BD ointment or the individual active ingredients, providing greater and faster reduction in disease severity. Cal/BD foam was also associated with rapid itch reduction.4 Based on a review of data across studies, a panel of experts has suggested that Cal/BD aerosol foam presents an effective, safe, and cost-effective option for management of psoriasis that is beyond mild.5

A newer topical fixed combination formulation of calcipotriene 0.005% and betamethasone dipropionate 0.064% in a cream base (Wynzora® Cream, EPI Health/MC2 Therapeutics) is now available on the market. It features a specialized multimolecular technology (Polyaphron Dispersion [PAD™] Technology) that encapsulates the active ingredients in microscopic oil droplets suspended in an aqueous vehicle. In clinical trials, Cal/BD cream outperformed Cal/BD topical suspension (TS) in terms of Physicians Global Assessment (PGA) and mean psoriasis area and severity index (PASI) improvement at week 8. Cal/BD cream was well tolerated, with no adverse event reported with a frequency greater than 1%.6 In the pivotal trials, patients expressed a preference for the Cal/BD cream formulation, indicating that it was more convenient than the topical suspension.7

The current study is intended to investigate comparative patient satisfaction between Cal/BD foam and Cal/BD cream formulations.
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