The Expert Committee noted that psoriasis is painful and disabling disease with a significant global burden and variable prevalence in different populations. The 2014 World Health Assembly resolution on psoriasis recognized the public health impact of psoriasis and the need for integrated management approaches. Severe forms of the disease are often treated using systemic therapies, but these can produce considerable toxicity and need careful monitoring. Topical treatment, such as calcipotriol, can be a valuable alternative, particularly for moderate disease.
The Committee noted that topical calcipotriol is more effective than placebo but not as effective as topical corticosteroids (e.g. betamethasone), a class of medicines that has been included in the EML since the first list was published. However, calcipotriol may be useful in patients who cannot tolerate corticosteroids or when toxicity associated with prolonged corticosteroid exposure becomes a problem. Calcipotriol has a favourable safety profile compared with topical corticosteroids due to low systemic absorption. It is easy to use, widely available and suitable for use in both adults and children.
The Expert Committee noted that, although there is limited evidence on the efficacy of calcipotriol for scalp psoriasis, it may be an appropriate alternative to prolonged topical use of corticosteroids on the scalp. Lotion formulations may provide greater patient acceptability for scalp application.
Therefore, the Expert Committee recommended the inclusion of calcipotriol on the core list of the EML and EMLc for the treatment of moderate forms of psoriasis.