Lipid-based calcipotriol formulation may improve treatment adherence in psoriasis vulgaris

Water-free, lipid-based spray formulations of calcipotriol were efficacious and safe in psoriasis vulgaris treatment and could potentially increase treatment adherence among patients, according to a study.

Calcipotriol, a vitamin D analogue, has been widely used in the treatment of psoriasis; however, a lack of adherence has rendered the medication ineffective at times. As a result, a new water-free lipid-based formulation spray has been developed.

“Nonadherence to topical treatment has been identified as an important issue in the management of psoriasis and is likely to affect the treatment outcome,” Jan Holmbäck, PhD, of the department of materials and environmental chemistry at Stockholm University in Stockholm, and colleagues wrote. “This novel formulation system offers all advantages of a new topical spray formulation without the drawbacks of poor patient compliance linked with traditional topical agents.”

In this single-center, randomized, double-blind, vehicle- and comparator-controlled trial, researchers evaluated the clinical efficacy and safety of once-daily, lipid-based calcipotriol formulations in patients with chronic psoriasis vulgaris.

In total, 24 participants (mean age, 53 years) received 10 applications of the formulations, AKVC01 and AKVC02, over a 12-day period.

Results showed that AKVC01 and AKVC02 demonstrated high anti-psoriatic effects with mean reductions in psoriatic infiltrate from baseline of –34% and –37%, respectively, compared with 6% and –4% in vehicle. The formulations showed comparable results to marketed calcipotriol solution and cream (–34% and –49%, respectively).

At a 1.7 clinical assessment score for both formulations, these scores were higher than the marketed calcipotriol solution’s 1.3 score, but not higher than the cream’s score of 2.

However, according to a consumer study referenced by the authors, the cosmetic properties of the lipid-based spray formulations vs. those of calcipotriol cream were preferred by a majority of patients due to the spray’s light texture and nongreasy residue after application.

A total of nine mild treatment-emergent adverse events were reported in four participants, who recovered by the next follow-up visit.

“Lipid-based calcipotriol as a novel formulation system seems to have all the necessary features to be used against topical disease like psoriasis owing to its enhanced efficacy and cutaneous safety,” Holmbäck and colleagues wrote. “AKVC02 has been chosen for further clinical development and will be reported in a forthcoming article.”