OVER THE past decade, vitamin D analogues have been intensively studied for the treatment of a number of dermatologic disorders. They were introduced with tremendous enthusiasm, and for many reasons that enthusiasm has been justified. Here was an entirely new class of medications for dermatologists. In the laboratory, calcipotriene, also called calcipotriol outside the United States, effectively reduced proliferation and induced differentiation of keratinocytes.1,2 These characteristics suggested that this vitamin D3 analogue would be effective in the treatment of psoriasis.
In clinical trials, calcipotriene therapy proved superior to anthralin therapy3 and to an assortment of topical corticosteroids including betamethasone valerate.4 Most recently, it has been shown to be more effective than fluocinonide ointment, a class II corticosteroid that is widely used for the treatment of psoriasis.5
See also page 1305
With this background, calcipotriene therapy was introduced in the United States in 1994. Expectations were high—possibly too high.