Topical Nicotinamide in Combination with Calcipotriol for the Treatment of Mild to Moderate Psoriasis: A Double-Blinded, Randomized, Comparative Study

Document Type : Original Article (s)

Authors

1 Assistant Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran AND Skin Diseases and Leishmaniasis Research Center AND Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Skin Diseases and Leishmaniasis Research Center AND Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Current treatment strategies of psoriasis are not completely satisfactorily. By inhibiting inflammatory cytokines, nicotinamide may enhance the effects of current topical treatments. We investigated whether the combination of topical calcipotriol and nicotinamide is more effective than calcipotriol alone in treatment of psoriasis.Methods: Adult patients with mild to moderate psoriasis were randomized to receive topical calcipotriol 0.005% and nicotinamide 4% in combination or calcipotriol 0.005% alone, twice daily for 12 weeks. Patients were visited by a dermatologist at baseline and then, after the first and third months of therapy; and psoriasis severity was evaluated using the modified psoriasis area and severity index (PASI). Also, patient’s satisfaction was evaluated at the end of the trial using a 10-point rating scale.Findings: Sixty five patients (35 men) with the mean age of 36.5 ± 8.5 years completed the trial. Lesions on both sides were similar regarding baseline PASI score. At the end of the trial, PASI score was more reduced with calcipotriol + nicotinamide (83.6 ± 7.9 percent) compared to calcipotriol alone (77.8 ± 9.7 percent) (P < 0.001). Patients were also more satisfied with the improvement of lesions with calcipotriol + nicotinamide compared to calcipotriol alone (P < 0.001). Side effects included mild erythema and pruritus (4.6%) and moderate burning and sensitivity to light (3.0%).Conclusion: Nicotinamide can enhance the efficacy of calcipotriol when used in combination for topical psoriasis treatment, and it may be a good adjuvant to the current treatment regimens of psoriasis.

Keywords

References

  1. Naldi L. Epidemiology of psoriasis. Curr Drug Targets Inflamm Allergy 2004; 3(2): 121-8.
  2. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol 2009; 60(4): 643-59.
  3. Mason AR, Mason J, Cork M, Dooley G, Edwards G. Topical treatments for chronic plaque psoriasis. Cochrane Database Syst Rev 2009; (2): CD005028.
  4. Namazi MR. Nicotinamide: a potential addition to the anti-psoriatic weaponry. FASEB J 2003; 17(11): 1377-9.
  5. Levine D, Even-Chen Z, Lipets I, Pritulo OA, Svyatenko TV, Andrashko Y, et al. Pilot, multicenter, double-blind, randomized placebo-controlled bilateral comparative study of a combination of calcipotriene and nicotinamide for the treatment of psoriasis. J Am Acad Dermatol 2010; 63(5): 775-81.
  6. Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol 2004; 4: 26.
  7. Morganti P, Berardesca E, Guarneri B, Guarneri F, Fabrizi G, Palombo P, et al. Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: a multicentre-randomized trial. Int J Cosmet Sci 2011; 33(5): 467-76.
  8. Dos SK, Barbhuiya JN, Jana S, Dey SK. Comparative evaluation of clindamycin phosphate 1% and clindamycin phosphate 1% with nicotinamide gel 4% in the treatment of acne vulgaris. Indian J Dermatol Venereol Leprol 2003; 69(1): 8-9.
  9. Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica 1978; 157(4): 238-44.
  10. Feldman SR. A quantitative definition of severe psoriasis for use in clinical trials. J Dermatolog Treat 2004; 15(1): 27-9.
  11. Bailey EE, Ference EH, Alikhan A, Hession MT, Armstrong AW. Combination treatments for psoriasis: a systematic review and meta-analysis. Arch Dermatol 2012; 148(4): 511-22.
  12. Kaufmann R, Bibby AJ, Bissonnette R, Cambazard F, Chu AC, Decroix J, et al. A new calcipotriol/betamethasone dipropionate formulation (Daivobet) is an effective once-daily treatment for psoriasis vulgaris. Dermatology 2002; 205(4): 389-93.
  13. Duweb G, Alhaddar J, Elsherif B, Eljehawi N, Makhlouf H. Calcipotriol-betamethasone ointment versus calcipotriol ointment in the treatment of psoriasis vulgaris. Drugs Exp Clin Res 2005; 31(5-6): 175-9.
  14. Kragballe K, Hoffmann V, Ortonne JP, Tan J, Nordin P, Segaert S. Efficacy and safety of calcipotriol plus betamethasone dipropionate scalp formulation compared with calcipotriol scalp solution in the treatment of scalp psoriasis: a randomized controlled trial. Br J Dermatol 2009; 161(1): 159-66.
  15. Luger TA, Cambazard F, Larsen FG, Bourcier M, Gupta G, Clonier F, et al. A study of the safety and efficacy of calcipotriol and betamethasone dipropionate scalp formulation in the long-term management of scalp psoriasis. Dermatology 2008; 217(4): 321-8.
  16. Zackheim HS. Topical 6-aminonicotinamide plus oral niacinamide therapy for psoriasis. Arch Dermatol 1978; 114(11): 1632-8.
Journal of Isfahan Medical School
Volume 32, Issue 314 - Serial Number 314
November and December 2015
Pages 2202-2209

Files

History

  • Receive Date: 28 February 2015
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics