Calcipotriol and betamethasone diproprionate

A combination treatment containing both a vitamin D analogue and a potent steroid is the most recent addition to the topical treatments for stable plaque psoriasis. It has been shown to be both quicker acting and more effective at reducing disease severity than calcipotriol on its own (Guenther et al., 2002). This same study showed that there was no statistical or clinical difference in the outcomes of using the combined product once or twice a day. It has consequently become recommended as a once-daily treatment.

Method of application
This is a once-daily treatment and should be applied in sufficient quantities to cover the plaque and then be gently rubbed in. As with calcipotriol it may not matter if some ointment gets onto unaffected skin, but this should be avoided where possible. Due to the inclusion of potent topical steroids, it is not recommended that the combination treatment should be used for more than 4 weeks. The British National Formulary suggests that further courses may be given after a period of not less than 4 weeks (British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008). The combination calcipotriol/steroid ointment may be helpful for an initial treatment of plaque psoriasis as it seems to be quicker acting; once resolution of the plaques begins this may be maintained by shifting the treatment regime to calcipotriol alone.