Duration of clinical improvement with oral tazarotene in plaque psoriasis

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Oral tazarotene has been shown to be highly effective for the treatment of moderate to very severe plaque psoriasis, significantly improving plaque elevation, scaling, erythema, and percentage body surface area involvement. As psoriasis is a chronic disease, the duration of clinical improvement obtained is of great importance to patients. Combined data from two 6-month multicenter, double-blind, randomized, placebo-controlled trials show that the clinical and statistical superiority of oral tazarotene (4.5 mg once daily) over placebo is maintained for at least 12 weeks post-treatment. The incidence of patients achieving 50% global improvement was 54% with tazarotene (15% with placebo) at the end of the 12-week treatment phase, with only a modest decline to 43% (12% with placebo) at the end of the 12-week follow-up phase. Thus, the incidence of tazarotenetreated patients with 50% global improvement after the 12-week follow-up phase was approximately 80% of the incidence after the 12-week treatment phase. The primary efficacy variable, clinical success, was defined as a 2-grade improvement in Overall Lesional Assessment (graded as none, minimal, mild, moderate, severe, or very severe). The incidence of patients achieving clinical success was 28% with tazarotene (6% with placebo) at the end of the 12-week treatment phase. Thus, the incidence of tazarotene-treated patients with clinical success after the 12-week follow-up phase was approximately 81% of the incidence after the 12-week treatment phase. Plaque elevation, scaling, and erythema were graded as 0 (none), 1 (mild), 2 (moderate), 3 (severe), or 4 (very severe). With tazarotene, the mean score for each of these parameters was reduced by a grade of 0.9, 0.9, and 0.8, respectively, at the end of the 12-week treatment phase, and 0.7, 0.7, and 0.7, respectively at the end of the 12-week follow-up phase. (The equivalent reductions with placebo were 0.3, 0.3, and 0.2, respectively at the end of the treatment phase and 0.2, 0.2, and 0.2 at the end of the post-treatment phase.) Thus, approximately 78 to 88% of the mean improvements in plaque elevation, scaling, and erythema attained with tazarotene treatment were maintained for at least 12 weeks post-treatment. The data suggest that even 12 weeks post-treatment the effect of oral tazarotene is maintained at approximately 80% of the level of clinical improvement obtained after 12 weeks of treatment.