Calcitriol ointment: optimizing psoriasis therapy.

The topical vitamin D3 modulator calcitriol, the naturally occurring active form of vitamin D3, has long been used for topical psoriasis therapy in Europe and other countries and was recently approved in the United States (U.S.) for the treatment of plaque psoriasis. In vehicle-controlled clinical trials, calcitriol 3 microg/g ointment has been shown to significantly improve the symptoms of psoriasis with a low incidence of adverse effects and without affecting calcium homeostasis, even when applied continuously for up to one year. A number of studies have examined the efficacy and safety of calcitriol ointment in combination therapy regimens that also included topical corticosteroid therapy or ultraviolet B (UVB) phototherapy. Calcitriol 3 microg/g ointment is a new option that provides flexibility for use in a variety of psoriasis treatment regimens. According to guidelines developed by the American Academy of Dermatology (AAD), the goals of psoriasis treatment are to produce durable remission of psoriasis symptoms, to achieve "substantial" clearing with the possibility of complete clearing, to maintain the initial benefits of therapy, and to minimize the risk of adverse events. Topical medications are the most commonly used treatments for psoriasis in the U.S. and are important in meeting the goals of psoriasis therapy. These agents offer high response rates with generally favorable safety and tolerability profiles and are useful for both acute treatment and long-term maintenance. Topical medications are used by approximately 85% of patients with psoriasis.