Topical treatment with nicotinamide may enhance efficacy of calcipotriol when used in combination for psoriasis treatment, according to recent results from a randomized, double-blinded, controlled trial.
Previous studies have indicated topical calcipotriol, a vitamin-D analog, is moderately efficacious for the treatment of psoriasis, whether used as monotherapy or in combination with other psoriasis medications.
Nicotinamide, a vitamin-B derivative, has shown in preliminary studies it can reduce proliferation of keratinocytes in the human skin, which indicates nicotinamide may be a good adjuvant to current psoriasis treatments, according to the researchers.
So researchers from the Department of Dermatology and Skin Diseases and Leishmaniasis Research Center at Isfahan University of Medical Science in Iran, investigated whether combination treatment with topical calcipotriol and topical nicotinamide is more effective than topical calcipotriol alone in treatment of psoriasis.
The investigators enrolled 65 patients age 18 to 65 years (35 male patients) with mild to moderate psoriasis and randomly assigned them to receive either topical calcipotriol 0.005% and nicotinamide 4% in combination or calcipotriol 0.005% alone twice daily (morning and before bed) for 12 weeks. Medication doses did not exceed 100 g/week.
At the end of the trial, patients in the calcipotriol plus nicotinamide group had greater reductions in their Psoriasis Area and Severity Index score compared with patients in the calcipotriol-only group (83.6 ± 7.9% vs. 77.8 ± 9.7%, P<0.001), according to the study findings.
Additionally, patients in the combined therapy group reported greater satisfaction with improvement of lesions compared with patients in the monotherapy group (P<0.001).
Treatment side effects for combination therapy included mild erythema and pruritus (4.6%) and moderate burning and sensitivity to light (3.0%).
“Nicotinamide can enhance the efficacy of calcipotriol when used in combination for topical psoriasis treatment and may be a good adjuvant to be added to the treatment regimens of psoriasis,” the researchers wrote. “Further trials with long-term follow-up are required to confirm these results and also to evaluate possible adverse effects with long-term use of nicotinamide.”