Abstract OVER THE past decade, vitamin D analogues have been intensively studied for the treatment of a number of dermatologic disorders. They were introduced with tremendous enthusiasm, and for many reasons that enthusiasm has been justified. Here was an entirely new class of medications for dermatologists. In the laboratory, calcipotriene, also called calcipotriol outside the United States, effectively reduced proliferation and induced differentiation of keratinocytes.1,2 These characteristics suggested that this vitamin D3 analogue would be effective in the treatment of psoriasis. In clinical trials, calcipotriene therapy proved superior to anthralin therapy3 and to an assortment of topical corticosteroids including betamethasone valerate.4 Most recently, it has been shown to be more effective than fluocinonide ointment, a class II corticosteroid that is widely used for the treatment of psoriasis.5 See also page 1305 With this background, calcipotriene therapy was introduced in the United States in 1994. Expectations were high—possibly too high. References 1. Kragballe K, Wildfang IL. Calcipotriol (MC903), a novel vitamin D3 analogue stimulates terminal differentiation and inhibits proliferation of cultured human keratinocytes . Arch Dermatol Res. 1990;282:164-167.Crossref 2. Binderup L, Bramm E. Effects of a novel vitamin D analogue MC903 on cell proliferation and differentiation in vitro and on calcium metabolism in vivo . Biochem Pharmacol. 1988;37:889-895.Crossref 3. Berth-Jones J, Chu AC, Dodd WA, et al. A multicentre, parallel-group comparison of calcipotriol ointment and short contact dithranol therapy in chronic plaque psoriasis . Br J Dermatol. 1992;127:266-271.Crossref 4. Cunliffe WJ, Claudy A, Fairiss G, et al. A multicenter comparative study of calcipotriol and betamethasone 17-valerate in patients with psoriasis vulgaris . J Am Acad Dermatol. 1992;26:736-742.Crossref 5. Bruce S, Epinette WW, Funicella T, et al. Comparative study of calcipotriene (MC903) ointment and fluocinonide ointment in the treatment of psoriasis . J Am Acad Dermatol. 1994;31( (part 1) ):755-759.Crossref 6. Weinstein G. Three decades of folic acid antagonists in dermatology . Arch Dermatol. 1983;119:525-527.Crossref 7. Parrish JA, Fitzpatrick TB, Tanenbaum L, Pathak MA. Photochemotherapy of psoriasis with oral methoxsalen and long-wave ultraviolet light . N Engl J Med. 1974;291:1207-1211.Crossref 8. Kragballe K. Vitamin D3 analogues in psoriasis . Dermatol Clin. In press. 9. Levy J, Gassmiller J, Schroder G, Audring H, Sonnichsen N. Comparison of the effects of calcipotriol, prednicarbate and clobetasol 17-propionate on normal skin assessed by ultrasound measurement of skin thickness . Skin Pharmacol. 1994;7:231-236.Crossref 10. Darley CR, Cunliffe WJ, Ferguson J, Hutchinson PE, Klaber MR. Safety and efficacy of calcipotriol ointment (Dovonex) in treating children with psoriasis vulgaris . Br J Dermatol. 1993;129( (suppl 46) ):133. 11. Ramsay CA, Berth-Jones J, Brundin G, et al. Long-term use of topical calcipotriol in chronic plaque psoriasis . Dermatology. 1994;189:260-264.Crossref 12. Green C, Ganpule M, Harris D, et al. Comparative effects of calcipotriol (MC903) solution and placebo (vehicle of MC903) in the treatment of psoriasis of the scalp . Br J Dermatol. 1994;130:483-487.Crossref 13. Tham SN, Lun KC, Cheong WK. A comparative study of calcipotriol ointment and tar in chronic plaque psoriasis . Br J Dermatol. 1994;131:673-677.Crossref 14. Kragballe K. Treatment of psoriasis by topical application of the novel cholecalciferol analogue calcipotriol (MC903) . Arch Dermatol. 1989;125:1647-1652.Crossref 15. Serum J, Fullerton A. Safety and skin irritation with vitamin D . In: Programs and abstracts of the Sixth International Psoriasis Symposium; July 20-24,1994; Chicago, Ill. 16. Dwyer C, Chapman RS. Calcipotriol and hypercalcaemia . Lancet. 1991;338: 764-765.Crossref 17. Mortensen L, Kragballe K, Wegmann E, Schifter S, Risteli J, Charles P. Treatment of psoriasis vulgaris with topical calcipotriol has no short-term effect on calcium or bone metabolism . Acta Derm Venereol (Stockh). 1993;73:300-304. 18. Hardman KA, Heath DA, Nelson HM. Hypercalcaemia associated with calcipotriol (Dovonex) treatment . BMJ. 1993;306:896.Crossref 19. Berth-Jones J, Bourke JF, Iqbal SJ, Hutchinson PE. Urine calcium excretion during treatment of psoriasis with topical calcipotriol . Br J Dermatol. 1993; 129:411-414.Crossref 20. Speight EL, Farr PM. Calcipotriol improves the response of psoriasis to PUVA . Br J Dermatol. 1994;130:79-82.Crossref 21. Hecker D, Martinez J, Sapadin A, Patel B, Lebwohl M. Effects of topical calcipotriene on transmission of ultraviolet light and effect of ultraviolet light on the stability of calcipotriene . J Invest Dermatol. 1995;104( (suppl) ):659. 22. Kragballe K. Combination of topical calcipotriol (MC903) and UVB radiation for psoriasis vulgaris . Dermatologica. 1990;181:211-214.Crossref 23. Kerscher M, Volkenandt M, Plewig G, et al. Combination phototherapy of psoriasis with calcipotriol and narrow band UVB . Lancet. 1993;343:923.Crossref 24. Kornreich C, Zheng ZS, Zhen Xue G, Prystowsky J. UV absorbance of topical agents commonly used in psoriasis treatment . J Invest Dermatol. 1995;104( (suppl) ):691. 25. McKenna KE, Stern RS. Photosensitivity associated with combined UV-B and calcipotriene therapy . Arch Dermatol. 1995;131:1305-1307.Crossref 26. Paus R, Schilli MB, Plonka P, et al. Topical calcitriol, calcipotriol and KH 1060 do not prevent chemotherapy induced alopecia in mice but accelerate hair regrowth and repigmentation . J Invest Dermatol. 1995;104( (suppl) ):659.
Archives of Dermatology – American Medical Association
Published: Nov 1, 1995
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