Optimizing Anti-Inflammatory and Immunomodulatory Effects of Corticosteroid and Vitamin D Analogue Fixed-Dose Combination Therapy
Por:
Segaert, S, Shear, NH, Chiricozzi, A, Thaci, D, Carrascosa, JM, Young, H and Descamps, V
Publicada:
1 sep 2017
Categoría:
Dermatology
Resumen:
Fixed-dose combination topical therapy with corticosteroid and vitamin D analog provides effective treatment and possible long-term management of psoriasis. The anti-inflammatory and immunomodulatory effects of corticosteroids and vitamin D analogs in treating psoriasis are well investigated; their complementary effects lead to the disruption of the inflammatory feedback loop underlying psoriasis pathogenesis. Recent preclinical data showed that combination therapy is more effective than monotherapies of the active ingredients in preventing activation of resting pro-inflammatory cells, inducing immunomodulation, reducing inflammatory responses by regulating T cell production, and normalizing keratinocytes. The increased understanding of the mechanism of action of fixed-dose combination therapy from preclinical studies is supported by several clinical studies. As the efficacy of topical therapy is correlated with the skin penetration of the active ingredients, new drug delivery systems have been developed. The fixed-dose combination Cal/BD aerosol foam creates a modified supersaturated formulation when applied to the skin, which is maintained for at least 26 h in the laboratory setting. Clinical studies have demonstrated superior efficacy of fixed-dose combination calcipotriol (Cal) 50 A mu g/g and betamethasone dipropionate (BD) 0.5 mg/g aerosol foam compared with monotherapies of the active ingredients. Furthermore, Cal/BD aerosol foam has shown significantly improved efficacy compared with more traditional formulations, such as Cal/BD ointment and gel, in other studies. Calcipotriol also mitigates risks associated with betamethasone dipropionate and vice versa, resulting in the favorable safety profile observed with fixed-dose combination treatment. Recent data also suggest that fixed-dose combination treatment could provide long-term management of psoriasis, although further clinical investigations are needed. Overall, these data support the value of fixed-dose combination therapy of corticosteroid and vitamin D analog and highlight the added potential of innovative drug delivery for the treatment of psoriasis.
LEO Pharma.
Filiaciones:
Segaert, S:
Univ Hosp Leuven, Dermatol Dept, Leuven, Belgium
Shear, NH:
Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Univ Toronto, Toronto, ON, Canada
Chiricozzi, A:
Univ Pisa, Dermatol Dept, Pisa, Italy
Thaci, D:
Univ Lubeck, Univ Hosp Schleswig Holstein, Comprehens Ctr Inflammat Med, Lubeck, Germany
:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Dermatol, Badalona, Spain
Young, H:
Univ Manchester, Manchester Acad Hlth Sci Ctr, Div Musculoskeletal & Dermatol Sci, Dermatol Res Ctr, Manchester, Lancs, England
Descamps, V:
Paris 7 Denis Diderot Univ, Bichat Claude Bernard Hosp, Dept Dermatol, Paris, France
gold, Green Published
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