Psoriasis 2000: the state-of-the-art today ... and tomorrow

This supplement reflects the proceedings of a symposium Psoriasis 2000: The state-of-the-art today … and tomorrow held on 25 September 2000 in Salvador de Bahia, Brazil and sponsored by Galderma. The symposium itself was convened to discuss the role of calcitriol in the overall context of psoriasis therapy. Undoubtedly, one of the major advances in our first-line management of chronic plaque psoriasis in the past decade has been the introduction of topical vitamin D3 analogues. Calcitriol is the newest addition to this family of pharmaceutical compounds. As with any new topical product, the efficacy and safety profiles of calcitriol need to be assiduously explored, particularly in the context of long-term usage and risk of hypercalcaemia. Comparisons with other available products in this class are also important to place calcitriol within the hierarchy of first-line topical treatments. Combination therapy is a natural development of any newly introduced treatment for psoriasis and, not too surprisingly, various studies have been performed to assess the efficacy of calcitriol in combination with other topical therapies and with ultraviolet B phototherapy. Understanding quality-of-life issues and psychological disability as key factors in the management of psoriasis are highly pertinent and, quite rightly, patients themselves are increasingly involved in developing outcome measures for this disease. The future of psoriasis therapy will, I hope, be a logical extension of the intensive molecular, immunological and biochemical research taking place on this disease at present. New therapies are not always, however, the outcome of logical stepwise progression and serendipity still has an important, although unpredictable, role to play in the development of such drugs. This symposium brought together experts from North America, South America and Europe to discuss calcitriol, its safety and efficacy, quality-of-life issues and the future for psoriasis research and therapy.