A recent study presented at the SDPA Annual Summer Dermatology Conference reveals that a combination therapy involving halobetasol propionate and tazarotene lotion offers substantial benefits in treating hyperkeratotic psoriasis, characterized by challenging moderate to severe scaling or plaque elevation.
Led by Linda F. Stein Gold, MD, the investigation highlighted that hyperkeratotic psoriasis, which manifests with pronounced plaques and scaling, poses significant treatment difficulties. The lotion’s formulation combines halobetasol propionate, known for its anti-proliferative effects, and tazarotene, which modulates gene expression, thereby potentially normalizing keratinocyte function observed in psoriasis. This combination, approved by the FDA in 2019 as Duobrii, represents the first topical treatment integrating these two agents for plaque psoriasis.
According to post hoc analyses of two phase 3 trials involving halobetasol propionate (0.01%) and tazarotene (0.045%) lotion, significant improvements in skin clearance were observed. The trials assessed patients with moderate to severe scaling or plaque elevation, utilizing a composite measure of the investigator’s global assessment (IGA) and affected body surface area (BSA). Notably, patients treated with the combination therapy achieved greater rates of IGA×BSA-75 (≥ 75% improvement from baseline) compared to those receiving vehicle lotion. By week 12, 42.2% of patients with scaling and 41.7% with plaque elevation achieved IGA×BSA-75, compared to 9.5% and 9.2% respectively in the control group.
Moreover, analyses of mean IGA×BSA changes demonstrated substantial improvements from baseline with halobetasol propionate/tazarotene therapy, reflecting a -24.7% to -46.3% reduction in scaling severity and a similar decrease in plaque elevation over the 12-week study period. In contrast, the vehicle group showed significantly lower improvements (-5.1% to -10.8% for scaling and -4.3% to -7.5% for plaque elevation).
Dr. Stein Gold emphasized that Duobrii’s dual action as a potent corticosteroid and retinoid offers synergistic efficacy, reinforcing its role as a pivotal treatment option for plaque psoriasis. The study’s findings underscore the lotion’s potential to address the persistent challenges associated with hyperkeratotic psoriasis, providing new hope for patients with difficult-to-treat conditions.
This research not only enhances understanding of effective treatment modalities for psoriasis but also paves the way for continued advancements in dermatologic care, aiming to improve outcomes and quality of life for affected individuals.
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