WebMD Medical News
Daniel J. DeNoon
Louise Chang, MD
Feb. 3, 2009 -- A new psoriasis treatment, Vectical, is the first
FDA-approved ointment containing calcitriol, the active form of vitamin D3.
The FDA has approved Vectical for use by adults 18 and older with
mild-to-moderate psoriasis. Studies in children are under way.
There's still no cure for psoriasis. But clinical trials show that Vertical
is safe during one year of continuous use.
"Because psoriasis is a chronic disease, topical products that are safe for
extended use must fit within overall, long-term treatment regimens," says Mount
Sinai School of Medicine dermatologist Mark Lebwohl, MD, in a news release. "A
safe, effective, long-term therapy is critical to improve overall outcomes for
Side effects of Vectical include changes in the way the body uses calcium.
People with known or suspected disturbances in calcium metabolism are warned to use Vectical with caution.
That warning also goes for people taking drugs, such as thiazide diuretics,
that affect calcium levels.
Caution is also advised for patients taking calcium or vitamin D supplements. And while using Vectical, patients are
warned against "excessive exposure" to natural or artificial sunlight. The
product has not yet been tested in pregnant or nursing women.
How well does Vertical work?
In two eight-week studies of more than 800 psoriasis patients with
mild-to-moderate psoriasis, about a third of patients had either psoriasis
plaque clearing or minimal psoriasis symptoms. Similar relief was seen by only
about a fifth of patients treated with the ointment base lacking the active
While Vectical is the only topical calcitriol product in the U.S., two other
products, Dovonex and Taclonex, contain a vitamin D derivative called
calcipotriene. Taclonex combines calcipotriene with a steroid. Another
psoriasis treatment, Tazorac, contains a vitamin A derivative.
One possible advantage of Vectical is that it can be applied to sensitive
skin-fold areas. Other vitamin D products have been linked to irritation in
Most doctors use corticosteroid treatments to get psoriasis flare-ups under
control. But these drugs typically are not indicated for long-term use.
Vectical is made by Galderma Laboratories, a joint venture of Nestle and
SOURCES:News release, Galderma Laboratories, Feb. 3, 2009.FDA approval letter, Jan. 23, 2009.National Psoriasis Foundation web site.ClinicalEvidence web site: "Psoriasis: Vitamin D Derivatives (updated)."
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