Linda Stein Gold, MD, on Halobetasol Propionate/Tazarotene Lotion for Psoriasis

Linda Stein Gold, MD, is director of clinical research and the division head of dermatology at the Henry Ford Health System in Detroit, MI. She recently was elected to the office of vice president-elect for the American Academy of Dermatology. Dr Stein Gold has authored more than 75 articles published in journals such as the New England Journal of Medicine and Journal of the American Academy of Dermatology. Her areas of expertise include psoriasis, alopecia, viral and fungal infections, and atopic dermatitis.

Dr Stein Gold spoke with The Dermatologist regarding her recent research on the fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion (HP/TAZ) and how dermatologists can utilize it when treating moderate to severe plaque psoriasis prior to her poster presentation at Maui Derm NP+PA Summer 2021.

Your June 2021 study¹ noted that HP/TAZ sustained treatment success, even after cessation for some participants. What does this say about the durability of HP/TAZ lotion?
We had seen in clinical trials with tazarotene for psoriasis as monotherapy that there was a durable effect even after discontinuing the medication. With the fixed combination of HP/TAZ, we see a similar effect with some patients continuing to improve after discontinuation of the drug and many having a durable effect.

How can HP/TAZ lotion affect patient quality of life?
Psoriasis has a tremendous impact on patient's quality of life, and the goal for any treatment regimen is long-lasting efficacy. We found that of the 56 participants who achieved an Investigator Global Assessment (IGA) score of clear, 28.6% did not require any further HP/TAZ retreatment, 53.6% did not require retreatment for at least 85 days, 62.5% did not require retreatment for at least 57 days, and 83.9% did not require retreatment for at least 29 days. This shows that it was possible to give some patients a drug holiday after they achieved clear skin.

How does the long-term safety (W52) compare with short-term (W12)?
There was a 1-year multicenter, open-label study in 555 adults with moderate to severe psoriasis. HP/TAZ was administered once daily for 8 weeks and then intermittently as needed in 4-week intervals for up to 1 year based on achievement of treatment success IGA clear or almost clear. Maximum continuous exposure was 24 weeks. There were marked improvements in severity of itching, dryness, and burning/stinging over the study course. The most common treatment-related adverse events were application site reactions of dermatitis, pruritus, pain, and irritation. The fixed-combination HP/TAZ lotion provided maintained efficacy with a favorable tolerability and safety profile, supporting its use for the long-term treatment and management of moderate-to-severe plaque psoriasis.

How does HP/TAZ lotion compare with other long-term management options for moderate to severe plaque psoriasis?
HP/TAZ has not been studied head-to-head with any other psoriasis treatment options over the long term, but this combination has been shown to be both safe and effective for intermittent use over 1 year.

Is there anything else notable about moderate to severe plaque psoriasis or HP/TAZ lotion that you would like to share?
The lotion vehicle utilizes an innovative polymeric emulsion technology that has been shown to result in higher permeation efficiency of the active ingredients compared with application of HP or TAZ cream alone. Most patients liked the attributes of the lotion vehicle and found it to be hydrating, moisturizing, and aesthetically pleasing. 

Reference
1. Lebwohl MG, Stein Gold L, Del Rosso JQ, Green L, Jacobson A. Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis. J Dermatolog Treat. Published online June 16, 2021. doi:10.1080/09546634.2021.1914310