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Alternating evening applications of tazarotene 0.1% gel and corticosteroid cream in the treatment of plaque psoriasis
Posters - Psoriasis and related disorders responded poorely to monotherapy and were given CyA and Actr in doses of 2-4 and 0.3-0.5 mgikg/d respectively. After a treatment period of 5-10 weeks, improvement was evident in 3 patients. Disease relapse was observed in one of two patients when CyA was stopped. A dose of CyA 2 and Actr 0.4 mg/kg/d was maintained in two cases. Hyperlipidaemia was the most usual and troublesome side effect. Overall, the combination of CyA and Actr was beneficial and without acute toxicity problems. I P447 Alternating evening applications
of tazarotene 0.1% gel and corticosteroid cream in the treatment of plaque psoriasis
L. Dubertret, M. Lahfa’, P Altmeye?, E.P Prens3, A. Matranga 4. ‘Hopital Saint Louis, Paris: 4Allergan Skin Care Clinical R&D, Mougins, France; 2S~.Josef’s Hospital, Ruhr Universitat, Bochutn, Germany; ‘Ziekenhuis Walcheren. Vlissingen and Erasmus University Rotterdam, The Netherlands In an investigator-masked, parallel-group study of 398 patients, tazarotene 0.1% gel was applied on alternating evenings with a vehicle cream or corticosteroid cream applied on intervening evenings for 12 weeks with a 4-week follow-up. The corticosteroid cream used was of low potency (hydrocortisone acetate l%), medium potency (alclometasone dipropionate O.OS%), or high potency (betamethasone valerate 0.1%). While tazarotene plus placebo achieved significant efficacy, tazarotene plus highpotency steroid was con-sistentiy more effective in reducing plaque elevation, scaling and erythema. The low- and mediumpotency steroids provided less substantial additional efficacy. Patients in the tazarotenelhigh-potency group achieved significantly higher treatment success rates (-50% improvement or better) with a more rapid onset of action. Treatment-related adverse events were clinically significantly lower (i.e., at least 10% lower) in the tazarotenelmedium- and tazarotenelhigh-potency groups compared with tazarotene/placebo. I P448
Cancer risk associated with the treatment of psoriasis
Kim Papp’, Pierre Beauparlant’. ‘Probity Medical Research, Waterlo; 2Novartis Pharmaceuticals Canada Inc. Dorval, Canada Though psoriasis does not itself contribute to life-time risk of malignancy, many of the common treatments are associated with an increased risk of skin cancer. We have evaluated the current data regarding altered life-time risk of malignancy attributed to the treatment of psoriasis. Of the topical treatments, tar is found to have an equivocal role in malignancy risk and despite widespread belief that UVB is associated with an increased risk of cutaneous malignancy, available data remains inconclusive. Squamous cell carcinoma however, are more frequent in individuals treated with PUVA whereas, the frequency of malignant melanoma appears only increased in individuals who have received high exposure to PUVA and have received their first PUVA treatment at least 15 years earlier. Azathioprine and cyclosporine (CyA) have been identified as increasing the risk of cutaneous as well as systemic malignancy but only
s291
few studies have reported an increased risk of non-malignant melanoma in patients (Pts) treated with methotrexate. The increased life-time risk of cancer is often measured by comparison with cancer incidences reported for the general population. Since psoriatic Pts are followed regularly by dermatologists, a potential bias exists since psoriatic Pts are more likely to be diagnosed earlier for skin cancer. Likewise, assessing attributable risk is a common confounding factor when multiple therapeutic modalities have been used in the same cohort. For instance, because the risk of skin cancer is greater in psoriatic Pts treated with CyA than other Pts treated with the same agent, it is likely that common psoriasis treatment such as PUVA contributes to the apparent increases in skin cancer risk associated with CyA.
IP449
External treatment of psoriasis with “Apulein”
J. Alimov, A. Abdurashidov, Z.G. Tukhvatullina. Research Institute of Dermatology and Venereology Tashkent, Uzbekistan Increase in prevalence of psoriasis among subjects of diverse age groups, prolonged and frequent chronic course, its treatment difficulties cause intent attention of investigators to search novel medicinal preparations. One of them is a dermal solution “‘Apulein” produced by chemical plant Gedeon Richter. Budezonid, acting substance in the composition of 0.025% solution “Apulein” is the most strong non-halogenized glycocortycoid of prednizolone range. Dermal solution “Apulein” contains 45% izopropanol of antiseptic action as solvent. By intensity of its local action the solution is of equal worth to halogenized derivatives. “Apulein” has been applied to 25 patients with psoriasis in the open study of therapeutical effect. Patients were aged from 17-77, of them 10 females, 15 males, 7 rural inhabitants, 18 urban ones. Pathological process was presented in infiltration nidi, papullferous and patches-shaped elements with peeling. Itch of different intensity was noted subjectively. “‘Apulein” was spred on the dermal area injured two times a day during 21 days. External treatment with “‘Apulein” was performed against a background of total conventional therapy. No other remedies of external therapy were administered. Clinical signs of psoriasis completely disappeared on the day 21 in 9 patients, efficient improvement was found in 12 patients, a partial one in 4 subjects, i.g. the total positive result was archieved in 25 patients. Thus, dermal solution ‘Apulein” may be recommended for treatment of psoriasis.
P4.50 El
“Apulein” solution in treatment of scalp psoriasis
D. Karimberdyev, Sh. Mavlyanova. Tashkent Institute of Advanced Medical Studies, Research Institute of Dermatology and Venetology, Uzbekistan Clinical trials of the novel preparation for external use “‘Apulein” solution have been performed to search new therapeutical potentialities in treatment of scalp psoriasis. It was synthesized by A/O Gedeon Richter. 30 patients aged 2153 with scalp psoriasis received preparation. Clinical results have been estimated by the following criteria: clinical recovery complete solution of clinical signs was observed in 7 patients,
of tazarotene 0.1% gel and corticosteroid cream in the treatment of plaque psoriasis
L. Dubertret, M. Lahfa’, P Altmeye?, E.P Prens3, A. Matranga 4. ‘Hopital Saint Louis, Paris: 4Allergan Skin Care Clinical R&D, Mougins, France; 2S~.Josef’s Hospital, Ruhr Universitat, Bochutn, Germany; ‘Ziekenhuis Walcheren. Vlissingen and Erasmus University Rotterdam, The Netherlands In an investigator-masked, parallel-group study of 398 patients, tazarotene 0.1% gel was applied on alternating evenings with a vehicle cream or corticosteroid cream applied on intervening evenings for 12 weeks with a 4-week follow-up. The corticosteroid cream used was of low potency (hydrocortisone acetate l%), medium potency (alclometasone dipropionate O.OS%), or high potency (betamethasone valerate 0.1%). While tazarotene plus placebo achieved significant efficacy, tazarotene plus highpotency steroid was con-sistentiy more effective in reducing plaque elevation, scaling and erythema. The low- and mediumpotency steroids provided less substantial additional efficacy. Patients in the tazarotenelhigh-potency group achieved significantly higher treatment success rates (-50% improvement or better) with a more rapid onset of action. Treatment-related adverse events were clinically significantly lower (i.e., at least 10% lower) in the tazarotenelmedium- and tazarotenelhigh-potency groups compared with tazarotene/placebo. I P448
Cancer risk associated with the treatment of psoriasis
Kim Papp’, Pierre Beauparlant’. ‘Probity Medical Research, Waterlo; 2Novartis Pharmaceuticals Canada Inc. Dorval, Canada Though psoriasis does not itself contribute to life-time risk of malignancy, many of the common treatments are associated with an increased risk of skin cancer. We have evaluated the current data regarding altered life-time risk of malignancy attributed to the treatment of psoriasis. Of the topical treatments, tar is found to have an equivocal role in malignancy risk and despite widespread belief that UVB is associated with an increased risk of cutaneous malignancy, available data remains inconclusive. Squamous cell carcinoma however, are more frequent in individuals treated with PUVA whereas, the frequency of malignant melanoma appears only increased in individuals who have received high exposure to PUVA and have received their first PUVA treatment at least 15 years earlier. Azathioprine and cyclosporine (CyA) have been identified as increasing the risk of cutaneous as well as systemic malignancy but only
s291
few studies have reported an increased risk of non-malignant melanoma in patients (Pts) treated with methotrexate. The increased life-time risk of cancer is often measured by comparison with cancer incidences reported for the general population. Since psoriatic Pts are followed regularly by dermatologists, a potential bias exists since psoriatic Pts are more likely to be diagnosed earlier for skin cancer. Likewise, assessing attributable risk is a common confounding factor when multiple therapeutic modalities have been used in the same cohort. For instance, because the risk of skin cancer is greater in psoriatic Pts treated with CyA than other Pts treated with the same agent, it is likely that common psoriasis treatment such as PUVA contributes to the apparent increases in skin cancer risk associated with CyA.
IP449
External treatment of psoriasis with “Apulein”
J. Alimov, A. Abdurashidov, Z.G. Tukhvatullina. Research Institute of Dermatology and Venereology Tashkent, Uzbekistan Increase in prevalence of psoriasis among subjects of diverse age groups, prolonged and frequent chronic course, its treatment difficulties cause intent attention of investigators to search novel medicinal preparations. One of them is a dermal solution “‘Apulein” produced by chemical plant Gedeon Richter. Budezonid, acting substance in the composition of 0.025% solution “Apulein” is the most strong non-halogenized glycocortycoid of prednizolone range. Dermal solution “Apulein” contains 45% izopropanol of antiseptic action as solvent. By intensity of its local action the solution is of equal worth to halogenized derivatives. “Apulein” has been applied to 25 patients with psoriasis in the open study of therapeutical effect. Patients were aged from 17-77, of them 10 females, 15 males, 7 rural inhabitants, 18 urban ones. Pathological process was presented in infiltration nidi, papullferous and patches-shaped elements with peeling. Itch of different intensity was noted subjectively. “‘Apulein” was spred on the dermal area injured two times a day during 21 days. External treatment with “‘Apulein” was performed against a background of total conventional therapy. No other remedies of external therapy were administered. Clinical signs of psoriasis completely disappeared on the day 21 in 9 patients, efficient improvement was found in 12 patients, a partial one in 4 subjects, i.g. the total positive result was archieved in 25 patients. Thus, dermal solution ‘Apulein” may be recommended for treatment of psoriasis.
P4.50 El
“Apulein” solution in treatment of scalp psoriasis
D. Karimberdyev, Sh. Mavlyanova. Tashkent Institute of Advanced Medical Studies, Research Institute of Dermatology and Venetology, Uzbekistan Clinical trials of the novel preparation for external use “‘Apulein” solution have been performed to search new therapeutical potentialities in treatment of scalp psoriasis. It was synthesized by A/O Gedeon Richter. 30 patients aged 2153 with scalp psoriasis received preparation. Clinical results have been estimated by the following criteria: clinical recovery complete solution of clinical signs was observed in 7 patients,