Applying moisturizer before HP/TAZ for psoriasis may improve tolerability
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Key takeaways:
- Applying moisturizer before the fixed-combination vs. after did not yield significant differences in efficacy.
- Two patients reported worse itching and irritation when treatment was applied first.
The order in which moisturizer and fixed-combination halobetasol propionate 0.01% and tazarotene 0.045% were applied did not affect efficacy, but it had a possible impact on tolerability in adults with psoriasis, according to a study.
“Fixed-combination halobetasol propionate 0.01% and tazarotene 0.045% (HP/TAZ) is indicated for the topical treatment of plaque psoriasis in adults,” Leon Kircik, MD, of the department of dermatology at Icahn School of Medicine at Mount Sinai, and Abby Jacobson, PA-C, of Ortho Dermatologics, wrote. “The efficacy and safety of HP/TAZ has been demonstrated in two phase 3 clinical trials in which participants were not instructed to moisturize. Thus, the optimal order in which to apply moisturizer and HP/TAZ has not been explored.”
In this study, Kircik and Jacobson evaluated the tolerability, safety and efficacy of applying a ceramide-containing moisturizer (CeraVe, L’Oreal Group) before vs. after applying HP/TAZ in patients (n = 16; mean age, 50 years) with mild to moderate plaque psoriasis.
Patients were instructed to apply the moisturizer before HP/TAZ on one side while applying moisturizer after HP/TAZ on the other side for 12 weeks.
Evaluations at week 4, 8 and 12 revealed that the order of application did not dictate the efficacy of HP/TAZ. In fact, both treatment regimens achieved improvement in plaque psoriasis, with 56% of the HP/TAZ-first regimen and 44% of the moisturizer-first regimen achieving an IGA score of 0 or 1.
All patients experienced significant improvements in Dermatology Life Quality Index scores (P .003) at all time points and VAS for itch (P < .008) at weeks 4, 8 and 12.
No serious adverse events were reported, but four moderate adverse events were experienced by three participants, with only itching and irritation in two patients being related to treatment. Both patients that reported itching and irritation stated the effects were worse on the side where HP/TAZ was applied first.
According to the authors, while both regimens yielded similar efficacy outcomes, the results of this study suggest that the application of moisturizer before HP/TAZ may improve patient tolerability.