Psoriasis Cure Now, a nonprofit patient advocacy group, has urged a joint hearing of two Food and Drug Administration Advisory Committees for approving the over-the-counter (OTC) sale of specific topical steroids that presently require a prescription.

Topical corticosteroids play a big role for treating psoriasis patients all over the world and approximately 6.5 million people in the United States alone. The advocacy group remarked that OTC status of these steroids can help in reducing medical costs and provide improved comfort.

From Medicalnewstoday.com:

Topical steroids come in dozens of variations in drug type and strength. One common classification system lists seven steroid potencies from mild to ultra high, with each of the seven classes offering numerous choices. For about 15 years, the strongest steroid available without a prescription has been hydrocortisone 1%, a very mild formulation.

In its statement to the FDA, the group called for better labeling and other education efforts both for patients and physicians about topical steroids and their potential side effects, and recommended particularly close attention to topical steroid use by pediatric psoriasis patients.

“While we believe additional steroids should be available OTC, we urge the FDA to weight carefully how best to educate parents who face difficult choices about how, and how aggressively, to treat psoriasis in their children,” Paranzino added. “Topical steroids play a role in treating many children with psoriasis, but there are non-steroid alternatives that should also be considered.”

Michael Paranzino, President of Psoriasis Cure Now, said that certain topical steroids require a prescription and can be safely used by psoriasis patients in an OTC setting.

Tags:  corticosteroids, OTC, psoriasis, Steroid use, Steroids, topical steroids

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Calcitriol, a form of vitamin D synthesized within the body, can possibly minimize growth-factor-induced HASM proliferation in cells in asthmatic as well as non-asthmatic people.

This finding was reported by researchers at the University of Pennsylvania who also noted that Vitamin D can slow down the progressive decline in breathing ability experienced in asthmatic patients due to human airway smooth muscle (HASM) proliferation.

From Sciencedaily.com:

With its anti-inflammatory qualities and its ability to inhibit smooth muscle proliferation, Dr. Damera said, calcitriol may become an important new therapy, used alone or in combination with already prescribed steroids, for treating steroid-resistant asthma.

Dr. Damera and his colleagues have also conducted experiments to determine the mechanism by which calcitriol retards HASM proliferation. They believe the vitamin works by inhibiting activation of distinct set of proteins responsible for cell-cycle progression.

The investigators have also conducted experiments to determine whether calcitriol, which is currently used to treat psoriasis, could be an effective therapy for COPD. Although preliminary, their data shows that calcitriol appears to reduce pro-inflammatory cytokine secretions in COPD. As with asthma, the researchers believe, calcitriol may also have the added benefit of slowing, if not stopping, the progression of airway remodeling. Others in the field believe calcitriol may also have the potential to inhibit the development and growth of several types of cancer.

A randomized control trial of calcitriol in patients with severe asthma with expectations of trial data in a year’s time is now being planned by the researchers as a part of the University of Pennsylvania’s Airway Biology Initiative.

Tags:  asthma, calcitriol, HASM, psoriasis, Steroids, Vitamin D

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Management of intertriginous psoriasis (IP) usually includes the application of topical corticosteroids, but those medications have adverse effects with long-term use. Fortunately, a study has revealed that a short-term application of topical corticosteroids and maintenance with a less potent agent can offer a reasonable approach for treating patients with IP.

From Bio-Medicine:

In this study, Alexander Kreuter, M.D, from Ruhr University of Bochum, Germany, and colleagues conducted a randomized controlled trial that compared 1 percent pimecrolimus (a new anti-inflammatory drug), 0.005 percent calcipotriol, 0.1 percent betamethasone and the vehicle (a similarly appearing cream with no active drug) in the treatment of IP with a four-week treatment period and a six-week follow-up without therapy. A total of 80 adult patients with the clinical diagnosis of IP were included, 20 patients in each of the four treatment groups.

The researchers report 25 percent of patients treated with pimecrolimus reported an increase in itching and burning shortly after application, however, most reactions lasted less than 30 minutes and resolved in a few days.

“In conclusion, this study indicated the efficacy of all three active compounds, 1 percent pimecrolimus, 0.1 percent betamethasone, and 0.005 percent calcipotriol (as well as the vehicle) in the treatment of IP. The 0.1 percent betamethasone was clearly more effective than 1 percent pimecrolimus, confirming that treatment with corticosteroids is still the most effective topical approach for psoriasis. However, their use in long-term management, particularly for the treatment of intertriginous areas is limited.

Psoriasis is an inflammatory skin disease. In a subset of patients, psoriasis is located in the intertriginous areas, including the skin folds of the underarms, breasts, groin, buttocks and genitals, according to background information in the article. Patients who exhibit IP complain about intense itching, irritation from sweating and soreness. These symptoms may have devastating psychological and emotional consequences.

Tags:  intertriginous psoriasis, IP, psoriasis, topical corticosteroids

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