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A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting.
Br J Dermatol. 2008 Feb; 158(2):375-81.BJ

Abstract

BACKGROUND

Calcipotriol ointment and short-contact dithranol cream therapy are well-established topical treatments for psoriasis. Quality of life, i.e. the physical, psychological, and social functioning and well-being of the patient, has become an essential outcome measure in chronic skin disease.

OBJECTIVES

To compare the quality-of-life outcomes of calcipotriol ointment with that of short-contact dithranol cream in a supervised treatment regimen, and to determine the degree of improvement in quality of life these topical treatments can accomplish.

METHODS

In a multicentre randomized controlled trial in six centres in the Netherlands, 106 patients with chronic plaque psoriasis were included, 54 receiving calcipotriol ointment twice daily and 52 dithranol cream once daily in a 12-week intensive treatment programme. Patients were treated at the day-care centre, using the care instruction principle of daily visits during the first week and twice-weekly visits subsequently for up to 12 weeks. Quality of life was assessed with the Skindex-29 and the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36).

RESULTS

At the end of treatment, no statistically significant differences were found between the calcipotriol and the dithranol group in any of the quality-of-life domains or scales of the Skindex-29 and the SF-36. Over time, a significant improvement of quality of life was found on all three scales of the dermatology-specific Skindex-29, predominantly of a moderate magnitude. In the calcipotriol group, a significant change of a small magnitude was found in the Physical Component Summary of the SF-36. No significant changes were found in the Mental Component Summary (or on any of the eight scales composing the questionnaire) of the SF-36.

CONCLUSIONS

The hypothesis was confirmed, that no statistically significant differences in improvement of quality of life could be found between calcipotriol ointment and dithranol short-contact cream in a day-care setting. Given this result, both calcipotriol and dithranol can be welcome alternatives for the patient. Calcipotriol, being more practical and patient friendly, can be considered as a first-line approach in clinical practice. However, in patients recalcitrant to calcipotriol and/or other topical treatments, preference should be given to the dithranol regimen. Topical treatment in combination with interventions explicitly focusing on improvement of coping behaviour and psychosocial functioning may further increase the degree of improvement in the psychosocial domains of quality of life. The results of this study are likely to give further evidence to the notion that the generic SF-36 is little or not responsive to small to moderate changes in quality of life in mild to moderate psoriasis.

Authors+Show Affiliations

Department of Dermatology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. j.dekorte@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18067483

Citation

de Korte, J, et al. "A Comparison of Twice-daily Calcipotriol Ointment With Once-daily Short-contact Dithranol Cream Therapy: Quality-of-life Outcomes of a Randomized Controlled Trial of Supervised Treatment of Psoriasis in a Day-care Setting." The British Journal of Dermatology, vol. 158, no. 2, 2008, pp. 375-81.
de Korte J, van der Valk PG, Sprangers MA, et al. A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting. Br J Dermatol. 2008;158(2):375-81.
de Korte, J., van der Valk, P. G., Sprangers, M. A., Damstra, R. J., Kunkeler, A. C., Lijnen, R. L., Oranje, A. P., de Rie, M. A., de Waard-van der Spek, F. B., Hol, C. W., & van de Kerkhof, P. C. (2008). A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting. The British Journal of Dermatology, 158(2), 375-81.
de Korte J, et al. A Comparison of Twice-daily Calcipotriol Ointment With Once-daily Short-contact Dithranol Cream Therapy: Quality-of-life Outcomes of a Randomized Controlled Trial of Supervised Treatment of Psoriasis in a Day-care Setting. Br J Dermatol. 2008;158(2):375-81. PubMed PMID: 18067483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting. AU - de Korte,J, AU - van der Valk,P G M, AU - Sprangers,M A G, AU - Damstra,R J, AU - Kunkeler,A C M, AU - Lijnen,R L P, AU - Oranje,A P, AU - de Rie,M A, AU - de Waard-van der Spek,F B, AU - Hol,C W, AU - van de Kerkhof,P C M, Y1 - 2007/12/07/ PY - 2007/12/11/pubmed PY - 2008/4/25/medline PY - 2007/12/11/entrez SP - 375 EP - 81 JF - The British journal of dermatology JO - Br J Dermatol VL - 158 IS - 2 N2 - BACKGROUND: Calcipotriol ointment and short-contact dithranol cream therapy are well-established topical treatments for psoriasis. Quality of life, i.e. the physical, psychological, and social functioning and well-being of the patient, has become an essential outcome measure in chronic skin disease. OBJECTIVES: To compare the quality-of-life outcomes of calcipotriol ointment with that of short-contact dithranol cream in a supervised treatment regimen, and to determine the degree of improvement in quality of life these topical treatments can accomplish. METHODS: In a multicentre randomized controlled trial in six centres in the Netherlands, 106 patients with chronic plaque psoriasis were included, 54 receiving calcipotriol ointment twice daily and 52 dithranol cream once daily in a 12-week intensive treatment programme. Patients were treated at the day-care centre, using the care instruction principle of daily visits during the first week and twice-weekly visits subsequently for up to 12 weeks. Quality of life was assessed with the Skindex-29 and the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36). RESULTS: At the end of treatment, no statistically significant differences were found between the calcipotriol and the dithranol group in any of the quality-of-life domains or scales of the Skindex-29 and the SF-36. Over time, a significant improvement of quality of life was found on all three scales of the dermatology-specific Skindex-29, predominantly of a moderate magnitude. In the calcipotriol group, a significant change of a small magnitude was found in the Physical Component Summary of the SF-36. No significant changes were found in the Mental Component Summary (or on any of the eight scales composing the questionnaire) of the SF-36. CONCLUSIONS: The hypothesis was confirmed, that no statistically significant differences in improvement of quality of life could be found between calcipotriol ointment and dithranol short-contact cream in a day-care setting. Given this result, both calcipotriol and dithranol can be welcome alternatives for the patient. Calcipotriol, being more practical and patient friendly, can be considered as a first-line approach in clinical practice. However, in patients recalcitrant to calcipotriol and/or other topical treatments, preference should be given to the dithranol regimen. Topical treatment in combination with interventions explicitly focusing on improvement of coping behaviour and psychosocial functioning may further increase the degree of improvement in the psychosocial domains of quality of life. The results of this study are likely to give further evidence to the notion that the generic SF-36 is little or not responsive to small to moderate changes in quality of life in mild to moderate psoriasis. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/18067483/A_comparison_of_twice_daily_calcipotriol_ointment_with_once_daily_short_contact_dithranol_cream_therapy:_quality_of_life_outcomes_of_a_randomized_controlled_trial_of_supervised_treatment_of_psoriasis_in_a_day_care_setting_ L2 - https://doi.org/10.1111/j.1365-2133.2007.08337.x DB - PRIME DP - Unbound Medicine ER -