Quality of Life Improvements after Psoriasis Cal/BD Aerosol Foam Treatment

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New real-world data has been published on the quality of life for patients with plaque psoriasis being treated with calcipotriol/betamethasone dipropionate (Cal/BD) aerosol foam.¹ In clinical trials, this combination of ingredients, especially in the aerosol foam formulation, has already demonstrated efficacy in patients with mild to moderate plaque psoriasis, thanks to its quick onset of action and convenient application.²

“However, its real-world impact on plaque psoriasis patients’ quality of life has not been evaluated thoroughly, despite the importance of subjective quality of life as a standard health outcome measure for chronic diseases,” the authors wrote.

The prospective, noninterventional, observational, open-label, multicenter, single-arm study took place at 25 centers in Spain and 9 in Portugal from October 2019 to May 2022. It involved 172 adult patients with plaque psoriasis were prescribed the treatment as a monotherapy for the first time. The mean age was 51 and over 55% of participants were male.

Investigators evaluated quality of life, treatment adherence, safety, satisfaction, change in body surface area (BSA), and overall efficacy 4 weeks after the first treatment and then after 6 months of daily administration. The Dermatology Life Quality Index (DLQI, Morisky-Green scale, and Treatment Satisfaction Questionnaire for Medication (TSQM-9) measurements were also used. The proportion of patients with DLQI scores of ≤ 1 after 4 weeks was the primary endpoint. 

At baseline, the mean percentage of affected BSA was 4.5%, mean PGA (Physician Global Assessment Scale) was 2.1, mean PaGA (Patient Global Assessment Scale) was 2.4, and the mean VAS (Visual Analog Scale) pruritus score was 5.6. These equated to a mild or moderate disease severity.

The average DLQI score at baseline was 7.2, with most patients expressing that their condition had a small or moderate impact on their lives. After 4 weeks, 53.5% had a DLQI score of ≤ 1. The mean change in DLQI from baseline was −4.2 after 4 weeks of treatment and −4.0 after the 6-month follow-up (p < 0.0001). Over 65% of patients who originally had a DLQI score ≥ 5 had an improvement of ≥ 4.5 points at the end of 4 weeks. Of these, 75.3% maintained this same result by the end of the study.

BSA was reduced by 2.4% after the first treatment period and then by 2.6% after 6 months, which was statistically significant (p < 0.0001). The mean PGA score also decreased to 1.1 after 4 weeks and then to 1.0 at the end of the observational period. Pruritus was also reduced to 2.5 and 2.6, respectively. Patients with DLQI ≤ 1 after 4 weeks of treatment had a lower BSA than patients with DLQI > 1.

According to the TQSM-9 global satisfaction score, satisfaction ratings changed from 78.3 after 4 weeks to 74.0 at the end of the study. The mean change in patient satisfaction throughout the entire trial was −4.3 (p = 0.0049). At 4 weeks, 85.3% of participants were satisfied and this was maintained for the remaining 6 months. About 96.3% of patients were at least moderately compliant, according to the Morisky-Green questionnaire. Additionally, higher satisfaction was correlated with lower DLQI scores, specifically after 4 weeks (r = −0.527; p < 0.0001).

The observational study design and limited sample size may be considered potential limitations. Additionally, the onset of the COVID-19 pandemic may have impacted patient selection, adherence, and follow-up periods. Future research with a higher number of participants, especially those with a BSA between 15% and 30%, is recommended.

References

1. Torres T, Martorell A, Leal Filipe P, et al. Real‐world impact of calcipotriol/betamethasone dipropionate aerosol foam on quality of life in patients with plaque psoriasis: A prospective observational study. Dermatologic Therapy. 2025;2025(1). doi:10.1155/dth/7529636

2. Rogalski C. Calcipotriol/betamethasone for the treatment of psoriasis: efficacy, safety, and patient acceptability. Psoriasis (Auckl). 2015;5:97-107. Published 2015 Jun 8. doi:10.2147/PTT.S63127