Mixed treatment comparison of a two-compound formulation (TCF) product containing calcipotriol and betamethasone dipropionate with other topical treatments in psoriasis vulgaris

Abstract

Objective:

The efficacy of the two-compound formulation (TCF) product containing calcipotriol and betamethasone dipropionate applied once daily in psoriasis has been demonstrated in phase III trials but no randomised clinical trial comparing all commonly used topical treatments exists. The aim of the study was to compare the efficacy of once-daily use of the TCF product relative to other commonly used topical agents in plaque psoriasis.

Research design and methods:

Data on change in Psoriasis Area and Severity Index (PASI) score from baseline and PASI 75 (percentage of patients achieving a 75% reduction in PASI score), after 4 weeks of treatment were obtained by means of a systematic literature review of randomised controlled trials and synthesised with a Bayesian mixed treatment comparison meta-analysis.

Results:

Relative to all active interventions, except for the unlicensed twice-daily application of the TCF product, the TCF once daily showed a greater efficacy based on PASI 75 response (relative risk ranging from 1.22 to 3.18) and improvement in PASI score from baseline (difference in % CFB PASI between TCF once daily and other active interventions ranged from 4.01 to 49.68).

Conclusion:

Among topical therapies evaluated, TCF once daily can be considered the most efficacious treatment for plaque psoriasis.

Key words::

• Mixed treatment comparison
• PASI 75
• Psoriasis
• Psoriasis treatment

Transparency

Declaration of funding

This study was funded by LEO Pharma A/S, Industriparken 55, DK-2750 Ballerup, Denmark who funded MAPI VALUES consulting services.

Declaration of financial/other relationships

P.C.M. van de Kerkhof has disclosed he has received consultancy fees from: Schering Plough, Celgene, Centocor, Allmirall, UCB, Wyeth, Pfizer, Soffinova, Abbott, Actelion, Galderma, Novartis, Jansen Cilag, LEO Pharma and carries out clinical trials for: Centocor, Wyeth, Schering Plough, Merck Serono, Abbott, Philips Lighting. Ria de Peuter, and Jeroen Jansen are employees of Mapi Values. Mapi Values received consultancy fees from LEO Pharma A/S related to this work. Jacob Ryttov is an employee of LEO Laboratories.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgements

The authors acknowledge the assistance of Dr Julia Bottomley in preparation of the paper. Dr Bottomley is an employee of Amygdala Ltd, which has received funding from LEO Pharma A/S for this help.