Table 2:  Design of and adverse events reported in studies of topical treatments of psoriasis

 

Treatment

Frequency

of

application

Design of study

& duration of

treatment

n

Proportion (%) of subjects with

treatment-related

adverse events

Specific treatment-related adverse events and proportion (%) affected

Proportion (%) withdrawn due to treatment-related

adverse events

Trial

Desonide lotion 0.05%

tid

C, D-B, R;

3 wk

30

3.3

(5.0)

Stinging: 3.3 (5.0)

0

 (10)

Greenspan, 1993

Clobetasol propionate 0.05% cream

tid

C, D-B, R, M;

2 wk

57

3.5

Burning: 3.5

Skin atrophy: 0

0

Jegasothy, 1985

Betamethasone valerate cream 0.1%

bid

C, D-B, R;

4 wk

179

4.0

Pruritus: 1.0

Burning: 2.0

Psoriasis exacerbation: 0.5 Folliculitis: 0.5

0

Callen, 1996

Fluticasone propionate cream 0.05%

bid

C, D-B, R;

4 wk

171

4.5

Pruritus: 3.0

Burning: 0.5

Dryness: 1.0

0

Callen, 1996

Tacalcitol ointment (4 íg/g)

qd

C, R, M;

8 wk

 

42

4.8

Irritation: 2.4

Erythema: 2.4

Pigmentation: 0

**

Farkas, 1999

Calcitriol ointment

(3 íg/g)

bid

C, R

8 wk

60

5.0

Skin irritation: 5.0

0

Hutchinson, 2000

Fluocinonide cream 0.05%

tid

C, D-B, R, M;

2 wk

57

5.3

Burning: 5.3

Skin atrophy: 0

0

Jegasothy, 1985

Betamethasone

dipropionate cream

0.05% (augmented)

qd

C, R, M;

2 wk

123

5.7

Pruritus: 1.6

Stinging: 0.8

Dermatitis: 0.8

Viral infection: 0.8

URI: 0.8

0

Ellis, 1989

Fluticasone propionate ointment

0.005%

bid

CT, D-B, R, M;

4 wk

193

6.7

 (6.3)

Burning and/or pruritus : 6.0 (6.0)

Hypertrichosis: 0.5

0

 (0)

Olsen, 1996

Desonide cream 0.05%

tid

C, D-B, R;

3 wk

30

6.7

Stinging: 3.3

Erythema: 3.3

0

Greenspan, 1993

Fluocinonide ointment 0.05%

bid

C, D-B, R, M;

6 wk

57

7.1

Pruritus: 1.8

Stinging: 1.8

Psoriasis exacerbation: 3.6

Acne: 1.8

1.8

Bruce, 1994

Fluocinonide cream 0.05%

bid

C, R, M;

12 wk

113

9.0

Pruritus: 1

Burning: 7

Erythema: 1

2

Lebwohl, 1998

 

Fluocinonide cream

0.05%

bid

C, R, M;

2 wk

121

9.1

 

Pruritus: 2.5

Stinging: 0.8

Pain: 0.8

Application site rxn: 0.8

Headache: 0.8

Fever: 0.8

Viral infection: 1.7

URI: 0.8

Follicular rash: 0.8

2.5

Ellis, 1989

Calcipotriene* ointment 0.005%

bid

C, D-B, R;

4 wk

63

9.5

Lesional pruritus/burning: 9.5

1.6

Salmhofer, 2000

Mometasone furoate 0.1% ointment

bid

C, D-B, R,M;

3 wk

205

10

Application site reaction: 8

Skin atrophy: 2.4

1.0

Koo, 1998

Betamethasone valerate ointment (1 mg/g)

bid

C, D-B, R, M;

6 wk

204

10.3

Lesional/perilesional irritation: 3.9

Irritation of face/scalp: 0.0

Erythema/desquamation: 1.5

Skin infection: 2.5

Misc. skin problems: 1.0

Nondermatologic: 1.5

1.5

Cunliffe, 1992

Calcipotriene*  ointment (50 íg/g)

bid

C, D-B, R, M;

8 wk

145

11.7

Pruritus: 1.4

Rash: 7.6

3.4

Veien, 1997

Mometasone furoate 0.1%/salicylic acid 5% ointment

bid

C, D-B, R,M;

3 wk

203

12

Application site reaction: 9

Skin atrophy: 3.0

0.5

Koo, 1998

Calcipotriene* ointment (CP) 0.005% / Diflucortolone valerate ointment 0.1% (DV)

CP: q am

DV: q pm

C, D-B, R;

4 wk

63

12.7

Lesional pruritus/burning: 12.7

0

Salmhofer, 2000

Tacalcitol ointment (4 íg/g)

qd

C, D-B, R, M;

8 wk

142

12.7

Pruritus: 7.0

Rash: 7.7

2.8

Veien, 1997

Mometasone furoate 0.1% ointment

bid

C, D-B, R, M;

3 wk

135

13

Pruritus: <1.0%

Burning: 1.0

Skin atrophy: <1.0%

0

Katz, 1998

Tazarotene gel 0.05%

qd

C, D-B, R,M;

8 wk

52

13

Pruritus/ Burning/ Erythema

 

3.8

Krueger, 1998

 

Calcipotriene* cream (CP) (50 íg/g) / Betamethasone 17- valerate cream (BM) (1 mg/g)

CP: q am

BM: q pm

 

CT, D-B, R, M;

8 wk

175

17.1

Lesional/ perilesional irritation: 22.9

1.7

Kragballe, 1998

Calcipotriene ointment 0.005%

bid

C, D-B, R, M;

6 wk

56

17.5

Pruritus: 7.0

Burning: 8.8

Erythema: 1.8

Rash: 1.8

Contact dermatitis: 1.8

0

Bruce, 1994

Coal tar (5%)/ allantoin (2%)/ hydrocortisone (0.5%) cream

bid

C, R, M;

8 wk

57

17.5

Pruritus/irritation/burning: 8.8

Erythema: 0

Soreness: 1.8

Rash: 1.8

Psoriasis exacerbation: 1.8

5.3

Pinheiro, 1997

Salicylic acid 5%

 

bid

C, D-B, R, M;

3 wk

67

18

Pruritus/ Burning

Skin atrophy: 0

0

Katz, 1998

Mometasone furoate 0.1%/salicylic acid 5% ointment

bid

C, D-B, R, M;

3 wk

133

20

Pruritus: 4.0

Burning: 5.0

Skin atrophy: 8.3

0

Katz, 1998

Calcipotriene ointment 0.005%

 

 

bid

CT, D-B, R, M;

8 wk

139

20.1

(15.2)

Rash: 10.8 (3.6)

Pruritus: 2.2 (2.9)

Burning: 2.2

Erythema: 2.9

(Psoriasis exacerbation: 4.3)

4.3

 (5.8)

Highton, 1995

Hydrocortisone buteprate 0.1% cream

bid

CT, D-B, R, M;

3 wk

94

23

 

Headache: 7.0

URI: 2.0

0

Sears, 1997

Calcipotriene* ointment (50 íg/g)

bid

C, R, M;

8 wk

65

23.1

Pruritus/irritation/burning: 12.3

Erythema: 6.2

Soreness: 1.5

Rash: 0

Psoriasis exacerbation: 1.5

1.5

Pinheiro, 1997


 

Calcipotriene* cream (CP) (50 ug/g) / Clobetasone 17-

Butyrate cream (CB) (0.5 mg/g)

CP: q am

CB: q pm

CT, D-B, R, M;

8 wk

172

23.8

Lesional/ perilesional irritation: 29.0

1.7

Kragballe, 1998

Calcipotriene* cream, suspended (50 íg/g)

bid

CT, D-B, R, M;

8 wk

161

26.1

Lesional/perilesional irritation: 10.6

Psoriasis exacerbation: 1.9

Misc. skin problems: 6.8

Nondermatologic: 4.3

1.2

Harrington, 1996

Calcipotriene* cream, dissolved (50 íg/g)

bid

CT, D-B, R, M;

8 wk

165

27.3

Lesional/perilesional irritation: 15.2

Psoriasis exacerbation: 0.6

Misc. skin problems: 4.8

Nondermatologic: 0.6

3.6

Harrington, 1996

Tazarotene gel 0.05%

qd

C, R,M;

12 wk

115

29

Pruritus: 9

Burning: 9

Erythema: 11

12

Lebwohl, 1998

Tazarotene gel 0.1%

 

bid

C, D-B, R,M;

8 wk

53

30

Pruritus/ Burning/ Erythema

 

7.5

Krueger, 1998

Calcipotriene* cream (CP) (50 íg/g) /

Vehicle (V)

CP: q am

V: q pm

CT, D-B, R, M;

8 wk

173

31.2

Lesional/ perilesional irritation: 37.6

4.6

Kragballe, 1998

Calcipotriene* ointment (50 íg/g)

bid

C, D-B, R, M;

6 wk

205

33.7

Lesional/perilesional irritation: 19.5

Irritation of face/scalp: 2.0

Erythema/desquamation: 3.9

Skin infection: 0.5

Misc. skin problems: 5.4

Nondermatologic: 2.9

2.4

Cunliffe, 1992

Calcipotriene* cream (50 íg/g)

bid

CT, D-B, R, M;

8 wk

172

34.3

Lesional/ perilesional irritation: 51.7

3.4

Kragballe, 1998

Calcipotriene* ointment (50 íg/g)

bid

C, R, M;

8 wk

239

35.0

Burning or lesional/ perilesional irritation: 20.0

Facial erythema or rash: 4.0

Misc. cutaneous symptoms at remote sites: 11.0

1.7

Berth-Jones, 1992


 

Tazarotene gel 0.5%

 

qd

CT, D-B, R, M;

12 wk

106

(107)

39

(15)

Pruritus: 17 (8)

Burning: 15 (6)

Erythema: 7 (1)

10

(3.0)

Weinstein, 1997

Dithranol stick

 

qd

(30 min.)

C, R, M;

8 wk

 

42

40.5

Irritation: 2.4

Erythema: 21.4

Pigmentation: 16.7

**

Farkas, 1999

Tazarotene gel 0.1%

 

qd

C, R, M;

12 wk

112

43

Pruritus: 18

Burning: 14

Erythema: 11

18

Lebwohl, 1998

Tazarotene gel 0.1%

 

 

Qd

CT, D-B, R, M;

12 wk

105

50

Pruritus: 23

Burning: 19

Ertythema: 8

12

Weinstein, 1997

Dithranol cream

 

qd

(30 min.)

C, R, M;

8 wk

239

53

Burning or lesional/ perilesional irritation: 48.0

Facial erythema or rash: 0.4

Misc. cutaneous symptoms at remote sites: 5.0

5.4

Berth-Jones, 1992

Dithranol cream

qd

(30 min.)

C, R

8 wk

54

72

Skin irritation: 72

3.7

Hutchinson, 2000


qd
, once daily; bid, twice daily; tid, three times daily; q am, once in the morning; q pm, once in the evening; CT, controlled trial; C, comparison study; D-B, double-blind study; R, randomized study; M, multicenter study; n, number of subjects included in intention to treat analysis; URI, upper respiratory infection.

 

Note:  For those treatments compared with vehicle, the proportion of subjects with treatment-related adverse events, specific treatment-related adverse events, and proportion withdrawn due to treatment-related adverse events are noted in parentheses within the corresponding row.

 

*Calcipotriene, the United States Adopted Name (USAN), is substituted for the European name of the vitamin D3 derivative, calcipotriol

 

**Proportion withdrawn due to treatment-related adverse events not specified