Effect of duration of application and dosing frequency on the efficacy of topical 0.1% mometasone furoate ointment in psoriasis

Abstract

Duration of application is believed to be an important determinant of efficacy of topical corticosteroids, but clinical studies are lacking. Mometasone furoate is recommended for once-daily use, despite a lack of studies comparing once-daily application with the conventional twice-daily application. We studied the efficacy of 0.1% mometasone furoate ointment in psoriasis with various application durations (randomized, observer-blind, bilateral-paired design), and once and twice-daily dosing frequencies (randomized, double-blind, vehicle-controlled, bilateral-paired design) in 64 consecutive patients with stable plaque psoriasis having equivalent symmetrical indicator lesions. Mometasone furoate ointment was applied in every patient to six indicator lesions for various application durations daily, and to two lesions with different dosing frequencies for up to 15 days. The main outcome measures were proportion of patients showing complete clearance and Local Psoriasis Severity Index scores on different days. With regard to the duration of application, there were no significant differences between 5 and 10 min, 10 and 15 min, 15 and 30 min, 30 min and 1 h, 1 and 6 h, 6 and 24 h, and 30 min and 24 h (P±0.2), but a 15-min application was less effective than a 24-h application (P = 0.03). Severity scores on all assessment days with various application durations were not significantly different (P±0.2). Once-and twice-daily dosing frequencies were equivalent for proportion of clearance (P = 0.17; 95% confidence interval, -5% to 27%) and severity scores on different days (P±0.09). This study shows that increasing the duration of application from 30 min to 24 h and the dosing frequency from once to twice daily do not increase the efficacy of mometasone furoate ointment in psoriasis.

Key Words:

• Mometasone furoate
• Psoriasis
• Treatment regimen