Comparison of efficacy, safety, and cost-effectiveness of topical salicylic acid 6% versus clobetasol propionate 0.05% in the treatment of limited chronic plaque psoriasis

Abstract

Aims: The aims of this study were to: (1) Comparison of Psoriasis Area Severity Index (PASI), Physician Global Assessment (PGA) Scores, and adverse effect profile on the use of topical salicylic acid 6% versus clobetasol propionate 0.05% in the chronic-limited plaque psoriasis.(2) Selection of the cost-effectiveness option using average cost-effective ratios of the two individual regimens. Materials and Methods: This was a randomized, open-labeled, parallel group design which was conducted at dermatology department of a tertiary care hospital located in resource-limited settings of South India. A total of 75 patients were recruited and randomized into two groups: Group A received 6% of topical salicylic acid and Group B received 0.05% of clobetasol propionate for 3 months with a three follow-up visits. Efficacy was assessed based on the reduction of PASI and PGA scores at each visit. The safety profile of two drugs was assessed by a screening of adverse drug reactions. Cost-effectiveness of treatment groups was calculated by considering inputs of direct medical costs required to reduce one unit on PGA scale. Results: Demographic and clinical profiles of participants were matched between two groups. The mean PASI score of Group A and Group B were reduced from baseline (4.36, 4.67) to final follow-up (1.97, 2.03). There was a statistically significant difference exist in mean PASI score difference of Group A and Group B from baseline to 1st follow-up and baseline to 2nd follow-up (P