Thirty-seven RCTs were included in the review with 6,038 participants.
Intention to treat (ITT) and remaining patient analyses led to the same conclusions.
Calcipotriol was at least as effective as potent topical corticosteroids, calcitriol, short contact dithranol, tacalcitol, coal tar, and combined coal tar 5%, allantoin 2%, and hydrocortisone 0.5%.
Calcipotriol versus placebo (8 trials, 1,185 participants) found that at six and eight weeks calcipotriol was more effective than placebo in adults. Based on the results of one trial calcipotriol was no better than placebo in children.
Calcipotriol caused significantly more skin irritation that potent topical corticosteroids (NNT to harm for irritation = 10, 95% CI: 6,34).
Calcipotriol monotherapy also caused more irritation than calcipotriol combined with a potent topical corticosteroid (NNT = 6, 95% CI: 4, 8).
The NNT for dithranol to produce lesional or perilesional irritation was 4 (95% CI: 3,5).
On average, treating 23 patients with short contact dithranol led to one more patient dropping out of treatment owing to adverse effects than if they were treated with calcipotriol. Significantly more patients withdrew from placebo compared with calcipotriol.