Tazarotene, halobetasol combination efficacious in scalp psoriasis
Scalp psoriasis was improved with a fixed combination of tazarotene and halobetasol propionate lotion, according to an open-label pilot study.
“About 80% of psoriasis patients have scalp involvement, which can be challenging to treat,” Elif Ozyurekoglu and Leon H. Kircik, MD, of the Ichan School of Medicine and Mount Sinai, wrote. “Fixed combination tazarotene 0.045% and halobetasol propionate 0.01% (Duobrii, Ortho Dermatologics) lotion has recently been approved for the treatment of moderate to severe plaque type psoriasis. The lotion base is suggested to confer benefits for application to the hair-bearing scalp.”
The open-label, single-center pilot study included 21 patients (average age, 52 years; 57% men; 95% white) with moderate to severe plaque psoriasis, as defined by an Investigator Global Assessment (IGA) scale value of 3 or 4 with scalp involvement.
Each patient was provided with the medication and instructed to apply the lotion to the affected areas once daily for 12 weeks.
IGA scores were improved significantly at weeks 4, 8 and 12 with 10 (48%) patients reaching clear or almost clear status by week 8 (P = .0006). At week 12, 40% of subjects remained clear or almost clear (P = .004).
Psoriasis scalp severity index (PSSI) 75 was achieved by 67% of patients at week 8, with 45% of patients maintaining PSSI 75 at week 12. PSSI 90 was achieved by 38% of subjects at week 8, with 30% maintaining at week 12. PSSI 100 was seen in 29% at week 8 with 20% maintaining at week 12.
Scalp IGA of clear or almost clear was achieved by 15 (72%) patients at week 8 with 50% maintaining through week 12. In addition, 29% had a completely clear scalp at week 8, with 20% maintaining at week 12.
There were no study-related adverse events.
“Scalp psoriasis is a significant concern for affected patients, and treatment has remained challenging,” the authors wrote. “Results of this pilot study demonstrate that fixed combination tazarotene 0.045% and halobetasol propionate 0.01% lotion is efficacious for the treatment of scalp psoriasis in adults, based on significant improvements in IGA, PSSI, BSA, sIGA and DLQI.”