Abstract
Biologic therapy has been an important addition to the armamentarium of psoriasis drugs as they offer high efficacy with a better side effect profile than systemic agents. However, there are cases in which patients do not respond rapidly or lose their initial response to biologic therapy, thus requiring additional treatment. While biologic therapy could be switched from one agent to another, in many cases, patients have had no adverse events (AEs) and the remaining lesions are minimal. In such cases, the addition of a topical agent may be the best choice. This single-center, open-label observational study enrolled 20 patients ≥18 years of age with plaque psoriasis with ≤5% body surface area (BSA) involvement. Patients received biologic therapy for at least 24 weeks prior to baseline. Topical combination therapy with desoximetasone spray 0.25% was added twice daily for 4 weeks and then decreased to twice-daily application on 2 consecutive days per week to week 16. Topical therapy was effective and well tolerated. Body surface area decreased −1.20 by week 4. Physician global assessment (PGA) score improved by −1.10 at week 4 and by −1.50 at week 16. The mean BSA × PGA score was 8.85 at baseline and had declined by −4.90 by week 4, an effect that was maintained to week 16. The combination therapy was well tolerated and safe. There were no AEs considered related to study medications and no steroid-related AEs such as atrophy, striae, telangiectasia, or folliculitis. Patients showed improvements in dermatology quality of life questionnaire scores. A treatment satisfaction questionnaire showed that overall patients were satisfied with the treatment regimen and found it to be convenient at all time points.
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