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Two-pronged Attack Best for Psoriasis Treatment

Posted: May 7, 2009

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The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“Another key finding is that combining two commonly used topical treatments—vitamin D analogues and a corticosteroid—is more effective than either treatment used on its own,” Mason said. “Using the two products separately, vitamin D in the morning and corticosteroid at night, can achieve similar effects, and be as well-tolerated, as using a specially combined product.”

Up to 40% of those who used vitamin D treatments had skin irritation and other side effects that led to lower levels of compliance. The topical corticosteroids showed less irritation, but had higher levels of thinning of the skin.

Mason noted that psoriasis is a lifelong disease, so patients likely will be using prescribed medications for very long periods. However, since most of the studies only followed participants between four and eight weeks, the authors were unable to come to any conclusions about extended use of these treatments.

“It is surprising how little adequate evidence is available addressing long-term safety of treatments or long-term management of psoriasis,” Mason said. “Patients should realize that most evidence is from short-term trials and that there is very little long-term evidence on benefits and potential harms to consider when deciding on maintenance strategies.”