Vitamin D analogues in the treatment of psoriasis

✍ Scribed by Knud Kragballe

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 641 KB
• Volume: 49
• Category: Article
• ISSN: 0730-2312
• DOI: 10.1002/jcb.240490109

✦ Synopsis

Psoriasis is a chronic hyperproliferative skin disease in which inflammatory and immunologic processes may play important pathophysiologic roles. Recently the skin has been identified as a target tissue for vitamin D. Because 1,25-dihydroxy vitamin D3 inhibits epidermal proliferation and promotes epidermal differentiation, it has been introduced for the treatment of psoriasis vulgaris. In addition to 1 ,25-(OH)2-D3, synthetic vitamin D3 analogues have undergone clinical evaluation. Calcipotriol (INN) (calcipotriene [USAN]) has been studied most extensively. Compared with 1 ,25-(OH)2-D3, calcipotriol is about 200 times less potent in its effects on calcium metabolism, although similar in receptor affinity. Topical calcipotriol 50 kg/g applied twice daily is efficacious and safe for the treatment of psoriasis.

Because topical calcipotriol is slightly more efficacious than betamethasone 1 7-valerate and dithranol, calcipotriol should be considered a first line drug in the management of psoriasis. These results illustrate that it is possible to separate the vitamin D effects on the cellular level from those on calcium metabolism not only in vitro, but also in a clinical setting. Q 1992 WiIey-Liss, tnc.