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Topical tacrolimus is not effective in chronic plaque psoriasis. A pilot study
I M Zonneveld1, A Rubins, S Jablonska
1Department of Dermatology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
Archives of Dermatology
|October 8, 1998
Summary
Topical tacrolimus ointment showed no significant difference compared to placebo for psoriasis treatment. Calcipotriol ointment was more effective than both tacrolimus and placebo.
Area of Science:
- Dermatology
- Immunosuppression
- Pharmacology
Background:
- Cyclosporine is a treatment for psoriasis, prompting research into derivatives with fewer side effects.
- Tacrolimus, an immunosuppressive drug, has shown systemic efficacy in psoriasis treatment.
- Topical tacrolimus offers a promising alternative with potentially fewer adverse effects for a broad patient population.
Purpose of the Study:
- To evaluate the efficacy of nonocclusive topical tacrolimus in treating psoriasis.
- To compare topical tacrolimus with calcipotriol and placebo ointments.
Main Methods:
- Patients were randomized to receive 0.005% calcipotriol ointment twice daily, placebo ointment once daily, or 0.3% tacrolimus ointment once daily.
- Treatment was applied to a single psoriatic plaque (40-200 cm2) after a 2-week washout period.
- Efficacy was assessed using the local psoriasis severity index after 6 weeks.
Main Results:
- The local psoriasis severity index showed a 62.5% reduction with calcipotriol, 33.3% with tacrolimus, and 42.9% with placebo after 6 weeks.
- No statistically significant difference was observed between tacrolimus and placebo ointments (P = .77).
- Calcipotriol ointment demonstrated superior efficacy compared to both tacrolimus and placebo ointments.
Conclusions:
- Topical tacrolimus ointment was not significantly more effective than placebo for psoriasis treatment.
- Calcipotriol ointment applied twice daily showed better results than once-daily tacrolimus or placebo ointments.