Patient preference is important to consider when prescribing long-term topical treatment regimens for psoriasis and can improve patient adherence and compliance.

Arash Taheri, MD, of Wake Forest University in Winston-Salem, North Carolina, and colleagues searched the literature through September 2013 for clinical trials that compared once-daily versus twice-daily application of calcipotriene plus betamethasone topical formulations for the treatment of psoriasis vulgaris.

Of 51 studies initially retrieved, two articles from one clinical trial were relevant and included. The single trial showed similar efficacy and safety when comparing the once-daily versus twice-daily application, the researchers reported in Clinical, Cosmetic and Investigational Dermatology.

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The 2002 international, multicenter, prospective, randomized, double-blind, parallel-group study by Guenther and colleagues lasted 4 weeks and included 828 patients. The study compared a combined ointment formulation of calcipotriene plus betamethasone used once daily versus twice daily for patients diagnosed with psoriasis vulgaris.

Results of the study indicated no statistically significant difference in the mean percentage change in the Psoriasis Area and Severity Index (PASI) from baseline to the end of treatment between the once-daily and twice-daily combined formulation groups.

However, the PASI reduction was significantly greater in the combined formulation groups (68.6% once daily, 73.8% twice daily) than in the twice-daily calcipotriol group (58.8%) or the vehicle group (26.6%).

Therefore, the investigators concluded that once-daily application of a topical combination treatment may offer increased patient convenience for long-term treatment, leading to increased patient adherence compared with twice-daily use and without reducing efficacy.

“To our knowledge, there is no evidence showing that more than once-daily application of any antipsoriatic drug can be more effective than once-daily use,” the researchers wrote. “Once-daily use of topical medications, including calcipotriene + betamethasone combination products, in psoriasis can help simplify the treatment regimen and offer increased patient convenience and potentially increased patient compliance with long-term treatment.”


  1. Shepherd J. Clin Cosmet Investig Dermatol. 2014:7 19-22.