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J Am Acad Dermatol. 2014 Nov;71(5):954-959.e1. doi: 10.1016/j.jaad.2014.05.040. Epub 2014 Jun 11.

An investigator-initiated, double-blind, vehicle-controlled pilot study: assessment for tachyphylaxis to topically occluded halobetasol 0.05% ointment in the treatment of psoriasis.

Author information

1
Laboratory for Investigative Dermatology, Rockefeller University, New York, New York. Electronic address: tczarnowic01@rockefeller.edu.
2
Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
3
Center for Clinical and Translational Science, Rockefeller University, New York, New York.
4
Department of Dermatology, Hadassah University Hospital, Jerusalem, Israel.

Abstract

BACKGROUND:

Topical corticosteroids are the most common first-line treatment for psoriasis. Tachyphylaxis, a decreased response to treatment with repetitive application of the drug, is a controversial phenomenon associated with topical corticosteroid treatment.

OBJECTIVE:

We sought to prove or disprove tachyphylaxis to occluded halobetasol 0.05% versus vehicle.

METHODS:

Patients with plaque psoriasis were recruited to this study. The study involved 3 phases (1, 2A, and 2B) with each phase being separated by a treatment vacation period. In phases 1 and 2A, 2 plaques were randomized to either halobetasol 0.05% or vehicle ointment application. In phase 2B, halobetasol 0.05% was applied to both. Target Lesion Severity Scale was used for clinical assessment.

RESULTS:

Twenty patients were enrolled. No difference in time to clearance (P=.88) or time to recurrence (P=.92) of the treated plaques was found between phases 1 and 2A. Percentage of improvement was higher in phase 2A compared with phase 1 (89.4%, P<.05 vs 71%, P<.05), as a result of reduction of vehicle effect. In phase 2B, a greater improvement was found for previously corticosteroid-treated plaques.

LIMITATIONS:

Limitations are small sample size and 1 corticosteroid tested.

CONCLUSION:

No evidence of tachyphylaxis to the topical corticosteroid halobetasol 0.05% ointment treatment in patients with plaque psoriasis was found.

KEYWORDS:

compliance; corticosteroid; halobetasol 0.05%; psoriasis; tachyphylaxis; vehicle

PMID:
24929883
DOI:
10.1016/j.jaad.2014.05.040
[Indexed for MEDLINE]

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