mometasone-furoate and tazarotene

Retinoids like tazarotene are approved for the treatment of chronic plaque psoriasis. In the beginning of topical retinoid therapy, 15-20% of the patients suffer from mild to moderate adverse reactions with burning and erythema. The aim of the study was to find predicative parameters of the individual irritative potential and to suggest options to reduce these initial irritations.. Twenty in-patients with different skin types (1 + 2: 11, 3 + 4: 9), with chronic plaque psoriasis were included in this open study. In each patient, 7 randomized plaques on the forearm were treated for 14 days on different ways: test area 1: morning (m) and evening (e) placebo, test area 2: placebo (m) and tazarotene 0.05% (e), test area 3: placebo (m) and tazarotene 0.1% (e), test area 4: calcipotriol (m) and calcípotriol (e), test area 5: mometasone furoate (m) and tazarotene 0.05% (e), test area 6: mometasone furoate (m) and tazarotene 0,1% (e), test area 7: placebo (m) and tazarotene in increasing concentrations (e), test area 8: healthy skin for control. Before and after therapy, skin barrier function, blood flow and plaque thickness in 20-MHz sonography were assessed in different test areas intraindividually by non- invasive biophysical measurements.. After 14 days of therapy, tazarotene 0.05% and 0.1% produced a stronger increase of laser Doppler flow in patients with skin type 1 and 2 than in patients with skin type 3 and 4. When using the combination therapy of tazarotene and mometasone, the laser Doppler flow was significantly lower than in tazarotene as monotherapy. 20-MHz-ultrasound showed a significant decrease in the thickness of the echo-poor band in all topical therapy regimens compared to placebo. Patients of skin type 1 and 2 reached a higher density of the dermis than patients of skin type 3 and 4, meaning a stronger decrease of inflammatory infiltration and acanthosis.. Adapting retinoid therapy to the patient's skin type can reduce the initial irritative side-effects. During the first days, patients with skin type 1 or 2 should add a medium potency corticosteroid. Stronger skin irritation caused by tazarotene therapy increases therapy effects.

Topics: Administration, Cutaneous; Adult; Calcitriol; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Forearm; Humans; Irritants; Male; Mometasone Furoate; Nicotinic Acids; Pregnadienediols; Psoriasis; Reproducibility of Results; Retinoids; Sensitivity and Specificity; Skin; Water Loss, Insensible

Topics: Adult; Aged; Anti-Inflammatory Agents; Dermatologic Agents; Drug Eruptions; Drug Therapy, Combination; Female; Follow-Up Studies; Gels; Humans; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Ointments; Pregnadienediols; Pruritus; Psoriasis; Skin; Treatment Outcome

Both tazarotene (a retinoid prodrug) and calcipotriene (a synthetic analog of vitamin D3) are effective in the treatment of plaque psoriasis, but no reports in the literature directly compare the efficacy and tolerability of these 2 drugs. Tazarotene is commonly used in conjunction with a topical corticosteroid. In this study, tazarotene was used with mometasone furoate (a synthetic corticosteroid), and the 2-drug regimen was compared with calcipotriene monotherapy.. This study was conducted to compare the efficacy and tolerability of tazarotene 0.1% gel once daily plus mometasone furoate 0.1% cream once daily with those of calcipotriene 0.005% ointment twice daily in the treatment of plaque psoriasis.. In this multicenter, investigator-blinded, parallel-group study, adult patients with chronic, stable plaque psoriasis affecting 5% to 20% of their body surface area were randomly allocated to receive up to 8 weeks of treatment with either tazarotene 0.1% gel once daily (in the evening) plus mometasone furoate 0.1% cream once daily (in the morning) or calcipotriene 0.005% ointment twice daily. Patients were assessed at baseline and at weeks 2, 4, and 8 of treatment. Patients who demonstrated complete clearance of plaque psoriasis after 2 or 4 weeks of treatment and those whose psoriasis had improved > or = 50% after 8 weeks of treatment entered a 12-week posttreatment follow-up phase during which they applied only moisturizer. Patients were reassessed after 4, 8, and 12 weeks of posttreatment follow-up. Physician-rated measures of efficacy included global improvement, plaque elevation, scaling, erythema, and percentage of body surface area involvement. Patient-rated assessments included efficacy of study treatment compared with previous therapies, comfort of treated skin, outlook for long-term control of psoriasis, and overall impression of treatment.. Of 120 patients with moderate to severe psoriasis enrolled from 3 centers, 106 (88%) completed the study. No significant differences in baseline clinical variables were observed between the 2 groups. Twenty-seven patients (45%) in the tazarotene plus cortico-steroid group achieved marked improvement (> or = 75% global improvement) after 2 weeks of treatment compared with 15 patients (26%) in the calcipotriene group (P < or = 0.05). Between-group comparisons of the percentage of patients achieving complete or almost complete clearance (> or = 90% global improvement) did not reach statistical significance at any time point. When compared with the calcipotriene regimen, the tazarotene plus corticosteroid regimen resulted in significantly greater efficacy on trunk lesions in reducing plaque elevation (at the end of treatment and at week 4 of the posttreatment phase, P < or = 0.05), scaling (week 4 of treatment and week 4 of the posttreatment phase, P < or = 0.05), erythema (week 4 of treatment and at the end of treatment, P < or = 0.05), and percentage of body surface area involvement (weeks 2 and 4 of treatment, P < or = 0.01). In addition, the tazarotene plus corticosteroid regimen was significantly more effective in reducing the percentage of body surface area involvement in upper limb lesions (weeks 2 [P < or = 0.05] and 4 [P < or = 0.01] of treatment). Forty-two of 55 patients (76%) in the tazarotene plus corticosteroid group rated their medication as more or much more effective than previous therapies compared with 30 of 52 patients (58%) in the calcipotriene group (P < or = 0.05). Although adverse events (burning, pruritus, irritation, and erythema) occurred in a significantly greater proportion of patients who received tazarotene plus corticosteroid than in those who received calcipotriene (P < or = 0.05), 47 of 55 patients (85%) in both groups rated the comfort of their treated skin as "somewhat comfortable" or better and both groups had similar discontinuation rates due to treatment-related adverse events (3% and 5%, respectively). CONCL

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Calcitriol; Dermatologic Agents; Drug Administration Schedule; Drug Therapy, Combination; Female; Gels; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Ointments; Pregnadienediols; Psoriasis; Treatment Outcome

A photographic tracking study was performed to facilitate a visual evaluation of the effect of treating psoriatic lesions in a clinical setting with tazarotene 0.05% gel, tazarotene 0.1% gel, tazarotene 0.1% gel plus mometasone furoate as needed for irritation, or tazarotene 0.1% gel plus mometasone furoate. Tazarotene was administered once daily in the evening, and mometasone furoate was administered once daily in the morning, for 12 weeks or until clearance if this occurred first. A total of twenty patients were enrolled in this open-label study. Rates of treatment success (50% or greater improvement in psoriasis) were higher with tazarotene 0.1% monotherapy compared with tazarotene 0.05% monotherapy, and were higher still when tazarotene was used in combination with mometasone furoate. Concurrent use of this steroid also enhanced speed of efficacy, patient satisfaction, and tolerability. Furthermore, long periods of remission were achieved in patients treated with combination tazarotene plus corticosteroid therapy. These findings suggest that tazarotene plus a mid-potency topical corticosteroid is a valuable first-line treatment option for stable plaque psoriasis.

Topics: Administration, Topical; Adult; Aged; Anti-Inflammatory Agents; Dermatologic Agents; Drug Therapy, Combination; Female; Gels; Glucocorticoids; Humans; Keratolytic Agents; Male; Middle Aged; Mometasone Furoate; Nicotinic Acids; Patient Satisfaction; Photography; Pregnadienediols; Psoriasis; Remission Induction; Retinoids; Time Factors; Treatment Outcome

Tazarotene is the first receptor-selective retinoid indicated for the topical treatment of plaque psoriasis. It is being used clinically in combination with other topical antipsoriatic treatments, although its stability in the presence of these products has not been examined extensively. This study examines the compatibility of tazarotene 0.05% gel with 17 other topical products used in the treatment of psoriasis, assessed over a 2-week period. Tazarotene showed minimal degradation (<10%) at 0, 8, 24, and 48 hours after compounding with each of the 17 products. In addition, after 1 and 2 weeks, degradation of tazarotene remained less than 10% for 15 of the 17 products tested. Tazarotene appeared to have minimal impact on the stability of the other products. These results suggest that tazarotene gel can be successfully coprescribed with a range of commonly used topical psoriasis treatments without adversely affecting the chemical stability of either agent.

Topics: Administration, Topical; Betamethasone; Calcitriol; Clobetasol; Dermatologic Agents; Drug Evaluation, Preclinical; Drug Incompatibility; Fluocinonide; In Vitro Techniques; Mometasone Furoate; Nicotinic Acids; Pregnadienediols; Psoriasis