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Corticosteroids effective as psoriasis treatment for up to 1 year

Corticosteroids effectively treated psoriasis when used for up to 52 weeks, compared with other topical treatments, according to study results.

Researchers conducted a systemic review and meta-analyses of randomized trial data of United Kingdom-licensed topical therapies. Clear or nearly clear status stratified for the trunk and limbs, and scalp was used as primary outcome.

There were 22,028 patients included in 48 studies on trunk and limb psoriasis and 17 studies on scalp psoriasis, and the majority of participants had at least moderate severity psoriasis. In all studies, treatment hierarchies were dominated by strategies containing potent corticosteroids (alone or in combination with a vitamin D analog) or very potent corticosteroids, while coal tar and retinoid treatments did not produce better results than placebo.

No significant differences in clear or nearly clear status were observed between corticosteroid treatment types, regardless of application rates or in combination with vitamin D analog.

Methodology and reporting showed variation between studies, including treatment duration (range: 2-12 weeks for trunk and limbs; 2-8 weeks for scalp; maintenance studies up to 52 weeks). There were significant differences in investigator and patient assessments of response for some interventions, including 78% and 39%, respectively, for use of very potent corticosteroids. While data were limited, no significant differences were reported for tolerability or steroid atrophy.

“Corticosteroids are highly effective when used continuously up to 8 weeks and intermittently for up to 52 weeks,” the researchers concluded. “Coal tar and retinoids are of limited benefit. There is a lack of long-term efficacy and safety data available on topical interventions used for psoriasis.

“A strategy for the maintenance of disease control in psoriasis is urgently needed. Future studies should ensure that patients’ evaluations of treatment are included as outcomes.”

Disclosure: See the study for a full list of relevant disclosures.