Evaluating calcipotriene 0.005% foam for the treatment of plaque psoriasis of the scalp and body in patients aged 12 years and older

ABSTRACT

Introduction: Topical corticosteroids are the mainstay of treatment for mild-to-moderate psoriasis in adult and adolescent patients but there can be many adverse events associated with long-term corticosteroid use. Corticosteroid-sparing alternatives include Vitamin D3 analogs, such as calcipotriene (also known as calcipotriol), which have long been used as monotherapy or combination therapy with other topical agents to treat psoriasis. Calcipotriene’s mechanism of action is not fully understood but it is believed to be effective due to its anti-proliferative and anti-inflammatory properties.

Areas covered: Herein, the authors review the safety and efficacy of calcipotriene 0.005% aerosol foam, as well as factors affecting patient adherence to topical therapies. The authors offer an expert opinion and future perspectives on the use of calcipotriene foam as monotherapy compared with other topical pharmacotherapies.

Expert opinion: Calcipotriene 0.005% foam is a safe and effective topical treatment when used to treat plaque psoriasis in patients aged 12 years and older. Despite its safety and efficacy, it remains largely utilized as a second-line agent due to its slow clinical improvement. Slow onset of action can result in poor patient adherence.

KEYWORDS:

• Calcipotriol
• corticosteroid-sparing
• monotherapy
• MC 903
• nonbiologic
• psoriasis
• topical
• vitamin D3 analogs

Article highlights

• One of the greatest barriers to achieving and maintaining improvements with topical anti-psoriatic therapies is the lack of patient adherence to usage of the medication as prescribed.

• Topical corticosteroid-sparing alternatives, such as calcipotriene 0.005% foam, can mitigate the adverse events associated with corticosteroid use. 

• Foam vehicles are associated with higher rates of patient adherence compared with other vehicles because the physical properties of foam formulations provide a more cosmetically elegant alternative to traditional vehicles.

• Calcipotriene works slowly, and due to the existence of more effective therapies, such as combination calcipotriene/betamethasone dipropionate 0.005%/0.064% foam, it is unlikely to become a preferred treatment option. 

• Calcipotriene 0.005% foam may fill a treatment gap for highly adherent patients who are refractory to or otherwise averse to topical corticosteroids.

Declaration of interest

S Feldman has received research, speaking and/or consulting support from: Galderma, GlaxoSmithKline/Stiefel, Almirall, Alvotech, Leo Pharma, Bristol-Myers Squibb, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Ortho Dermatology, AbbVie, Samsung, Janssen Pharmaceuticals, Eli Lilly and Company, Menlo, Merck & Co, Arena, Forte, Helsinn, Novartis, Regeneron, Sanofi, Novan, Qurient, the National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and the National Psoriasis Foundation. He is also the founder and majority owner of www.DrScore.com as well as the founder and part owner of Causa Research. LC Strowd has received funding or support from Galderma, Sanofi Regeneron, Pfizer and Actelion. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.