G.2Chapter 7: Topical therapies for chronic plaque psoriasis

G.2.1. Topical therapies for trunk and limb chronic plaque psoriasis

In people with chronic plaque psoriasis of the trunk and/or limbs, what are the clinical effectiveness, safety, tolerability, and cost effectiveness of topical vitamin D or vitamin D analogues, potent or very potent corticosteroids, tar, dithranol and retinoids compared with placebo or vitamin D or vitamin D analogues, and of combined or concurrent vitamin D or vitamin D analogues and potent corticosteroids compared with potent corticosteroid or vitamin D or vitamin D analogue alone?

Excluded n = 6

Study excludedReason
Augustin M, Peeters P, Radtke M et al. Cost-effectiveness model of topical treatment of mild to moderate psoriasis vulgaris in Germany. Dermatology. 2007; 215(3):219–228. Ref ID: AUGUSTIN2007Partially applicable, very serious limitations
Freeman K, Marum M, Bottomley JM et al. A psoriasis-specific model to support decision making in practice - UK experience. Curr Med Res Opin. 2011; 27(1):205–223. Ref ID: FREEMAN2011Partially applicable, very serious limitations
Harrington CI. Cost-effectiveness analysis of calcipotriol ointment and ‘short-contact’ dithranol in treating mild-to-moderate psoriasis. Br J Med Econ. 1995; 8:27–32. Ref ID: HARRINGTON1995Partially applicable, very serious limitations
Marchetti A, LaPensee K, An P. A pharmacoeconomic analysis of topical therapies for patients with mild-to-moderate stable plaque psoriasis: a US study. Clin Ther. 1998; 20(4):851–869. Ref ID: MARCHETTI1998Partially applicable, very serious limitations
Peeters P, Ortonne JP, Sitbon R et al. Cost-effectiveness of once-daily treatment with calcipotriol/betamethasone dipropionate followed by calcipotriol alone compared with tacalcitol in the treatment of psoriasis vulgaris. Dermatology. 2005; 211(2):139–145. Ref ID: PEETERS2005Partially applicable, very serious limitations
Schwicker D, Dinkel R, Antunes H. A cost-comparison study: ulobetasol versus clobetasol in severe localized psoriasis. J Dermatol Treat. 1992; 2(4):127–131. Ref ID: SCHWICKER1992Partially applicable, very serious limitations

G.2.2. Topical therapies for high impact or difficult to treat sites

In people with psoriasis at high impact or difficult-to-treat sites (scalp, flexures, face), what are the clinical effectiveness, safety, tolerability and cost effectiveness of vitamin D or vitamin D analogues, mild to very potent corticosteroids, combined or concurrent vitamin D or vitamin D analogue and potent corticosteroid, pimecrolimus, tacrolimus, tar, dithranol and retinoids compared with placebo, corticosteroids or vitamin D or vitamin D analogues?

Excluded n = 0

From: Appendix G, Excluded studies list (cost effectiveness)

Cover of Psoriasis
Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
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