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An Update on Vitamin D₃ Analogues in the Treatment of Psoriasis

1998; Karger Publishers; Volume: 11; Issue: 1 Linguagem: Inglês

10.1159/000029803

1660-5535

P.C.M. van de Kerkhof,

Vitamin C and Antioxidants Research

Vitamin D₃ analogues have revolutionized the topical treatment of psoriasis during the last decade. The mode of action of this ligand for the vitamin D₃ receptor is via modulation of the transcription of genes with vitamin D₃ response elements in their promoter region. Vitamin D₃ analogues cause inhibition of various aspects of cutaneous inflammation and epidermal proliferation with enhancement of normal keratinization. In vivo, active vitamin D₃ analogues proved to have a substantial antipsoriatic effect. Calcipotriol (50 µg/g in ointment or cream), tacalcitol (4 µg/g in ointment) and calcitriol (3 µg/g in ointment) have been shown to have an antipsoriatic effect in placebo-controlled studies. The most extensive body of information on comparative studies and on combination therapies is available for the analogue calcipotriol. So far, calcipotriol is available as a routine treatment in most countries, whereas tacalcitol has been registered in Japan and some European countries. From the available data in the literature we may conclude that calcipotriol is a first-line treatment for psoriasis and is advantageous in the combination with several other antipsoriatic treatments suchs as topical corticosteroids, PUVA, cyclosporin and acitretin. Tacalcitol 4 µg/g as a once-daily principle is effective in psoriasis. Comparative studies will indicate the position of the existing and new vitamin D₃ analogues.