Calcipotriol vs. Anthralin in the treatment of chronic plaque psoriasis

This trial is a prospective, open and randomised parallel-group comparison of the therapeutic efficacy and safety of short contact treatment with anthralin (2 %) vs. topical calcipotriol in two groups of inpatients with chronic plaque psoriasis. The patients of the second group (N = 35) received topical calcipotriol ointment (50 μg/g) twice daily. The patients of the first group (N = 35) used a single application of anthralin ointment (2 %) for 30 minutes daily. The extent and the severity of psoriasis were assessed by PASI-score before and 2, 4, 6, 8 and 10 weeks after onset of treatment. The difference between the two treatments was statistically significant in favor of short contact anthralin already after the first two weeks of therapy and remained so until the end of the trial. After 10 weeks of therapy the mean PASI-score fell from 7.31 to 0.34 in the anthralin group (p < 0.001) and from 6.92 to 2.58 in the calcipotriol group (p < 0.001). Irritation and burning of the apparently normal perilesional skin occured under both therapeutic regimens but were more frequent in the anthralin group (16/35, 45.7 %), as compared to the calcipotriol group (5/35, 14.2 %). No statistically significant alterations of laboratory findings were observed in the groups during treatment, as compared to the pre-treatment period. In particular no increase in serum calcium levels above the normal range was observed in the patients of either groups. These findings indicate that short contact anthralin is more effective than topical calcipotriol in the treatment of in-patients with chronic plaque psoriasis but is associated with more frequent adverse reactions.