human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: IMPORTANCE Attempts to use topical cyclosporine in treatment of psoriasis have failed because of unfavorable physicochemical properties and inappropriate formulation design of the conventional dosage forms . OBJECTIVE To evaluate the efficacy of topical cyclosporine using liposomal nanocarriers ( lipogel ) in limited chronic plaque psoriasis . DESIGN , SETTING , AND , PARTICIPANTS A single-center r and omized clinical trial was conducted using a 3-arm parallel group , double-blind , vehicle and active comparator design and included 38 patients with chronic plaque psoriasis measuring less than or equal to 100 cm2 performed in a tertiary care hospital . INTERVENTIONS In the first arm , a total of 24 patients were r and omized to receive either cyclosporine lipogel , 2.0 % weight by weight ( w/w ) , or placebo lipogel . In the second arm , 7 patients were r and omized to receive cyclosporine lipogel , 2.0 % , or conventional cyclosporine cream , 2.0 % w/w . The third arm comprised 7 patients r and omized with cyclosporine lipogel , 2.0 % or st and ard clobetasol propionate cream , 0.05 % w/w . Patients were examined twice weekly for 14 weeks , or until total lesional clearance was observed , whichever was earlier . MAIN OUTCOMES AND MEASURES The primary outcome measure was the dermatological sum score ( DSS ) assessing erythema , scaling , and plaque elevation on a 4-point scale ( 0 , absent ; 1 , minimal ; 2 , moderate ; 3 , severe ) . RESULTS In 38 patients ( 23 men and 15 women with a mean [ SD ] age range from 35 [ 8 ] to 40 [ 13 ] years ) , a 19 % decrease in DSS score from a mean ( SD ) of 8.45 ( 0.67 ) to 6.82 ( 0.77 ) compared with baseline was observed after 2 weeks of treatment with cyclosporine lipogel , 2.0 % w/w ( P < .001 ; 95 % CI , 13.77 - 24.51 ) in 59 % of psoriasis lesional sites . At the end of the eighth week , a significant reduction ( approximately 83 % ) in DSS was seen in all sites treated with cyclosporine lipogel , ( P < .001 ; 95 % CI , 77.48 - 88.22 ) . At the end of the study period , complete clearance ( ie , DSS = 0 ) was observed in 16 ( 41 % ) psoriasis lesional sites treated with cyclosporine lipogel , 85.7 % of sites treated with clobetasol propionate cream , and none of the sites treated with conventional cyclosporine cream or placebo gel . CONCLUSIONS AND RELEVANCE Topical liposomal formulation of cyclosporine , 2.0 % w/w , is effective in treatment of limited chronic plaque psoriasis  with a satisfactory safety profile . Future clinical trials should assess liposomal cyclosporine in larger study population s. TRIAL REGISTRATION Clinical Trials Registry-India Identifier : CTRI/2011/12/002307 Abstract Background Fixed combination calcipotriol 50 μg/g ( Cal ) plus betamethasone 0.5 mg/g ( BD ) foam has been developed as a new treatment option for patients with psoriasis . Methods The r and omized , parallel‐group , investigator‐blinded Phase III , 12‐week PSO‐ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel .  Patients aged ≥18 years with mild‐to‐severe psoriasis were r and omized 4:4:1:1 to once‐daily Cal/BD foam , Cal/BD gel , foam vehicle or gel vehicle ( NCT02132936 ) . The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician 's global assessment of disease severity ( i.e. treatment success ) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel . Secondary efficacy endpoints included : proportion of patients achieving at least a 75 % reduction in modified psoriasis area and severity index ( mPASI75 ) , and time to treatment success ( TTTS ) . Safety was monitored throughout . Results A total of 463 patients were r and omized : Cal/BD foam ( n = 185 ) , Cal/BD gel ( n = 188 ) , foam vehicle ( n = 47 ) , gel vehicle ( n = 43 ) ; overall completion rate was 90 % . Cal/BD foam achieved higher treatment success rates ( 38 % vs. 22 % ; P < 0.001 ) and mPASI75 ( 52 % vs. 35 % ; P < 0.001 ) by week 4 than Cal/BD gel by week 8 . Median TTTS with Cal/BD foam was 6 weeks ; this could not be determined for Cal/BD gel as 50 % treatment success was not achieved ( P < 0.001 ) . Adverse drug reactions were reported in 14 ( 7.6 % ) Cal/BD aerosol foam patients and 7 ( 3.7 % ) Cal/BD gel patients ; all were single events except for itch with Cal/BD aerosol foam ( n = 5 ; 2.7 % ) and worsening psoriasis with Cal/BD gel ( n = 3 ; 1.6 % ) . Conclusion Cal/BD aerosol foam showed significantly greater efficacy after 4 weeks , than 8 weeks of treatment with Cal/BD gel , with similar tolerability Abstract Background Topical therapies are the mainstay of treatment for psoriasis vulgaris . The fixed combination of calcipotriol ( Cal ) 50 μg/g plus betamethasone 0.5 mg/g ( as dipropionate ; BD ) is a first‐line topical treatment and available as a gel or ointment . The use of these fixed combination products was compared in PRO‐long , a long‐term noninterventional study , for which interim results ( 4 and 12 weeks ) have previously been reported . Objective To describe and compare patients ’ perspectives on the fixed combination gel and ointment formulations ; to include efficacy , adherence behaviour , treatment satisfaction and health‐related quality of life ( HRQoL ) aspects during long‐term real‐life psoriasis management . Methods PRO‐long was a multicentre , prospect i ve , observational , 52‐week study of patients prescribed fixed combination Cal/BD gel or ointment in clinical practice . For final analysis the following were assessed at weeks 24 , 36 and 52 : differences in the proportion of patients with ‘ mild’/‘very mild ’ disease according to patient 's global assessment of disease severity , adherence behaviour , treatment satisfaction ( nine‐item treatment satisfaction question naire for medication ) and HRQoL ( Skindex‐29 ) . Results Patients ( n = 328 ) were prescribed once‐daily Cal/BD gel ( n = 152 ) or ointment ( n = 176 ) . At week 52 , a higher proportion of patients reported that the severity of their psoriasis was ‘ mild’/‘very mild ’ vs. baseline ( gel : 60.2 vs. 47.1 % ; ointment : 58.8 vs. 42.4 % ) , with greater treatment satisfaction reported in patients using gel vs. those using ointment . A higher proportion of patients found the gel ‘ easy ’ to use compared with the ointment ( 66.7 vs. 45.2 % ) . Daily application of treatment took ≤5 min for 86.1 % of patients using gel and 71.0 % of patients using ointment . Conclusion This real‐life study has demonstrated similar effectiveness between the Cal/BD formulations . However , over a 52‐week treatment period , patients reported greater treatment satisfaction with the gel , which was considered easier to use , faster to apply and overall a more convenient product Abstract Background : An aerosol foam formulation of fixed combination calcipotriene 0.005 % ( as hydrate ; Cal ) plus betamethasone dipropionate 0.064 % ( BD ) was developed to improve psoriasis treatment . Objectives : To compare the efficacy and safety of Cal/BD aerosol foam with Cal/BD ointment after 4 weeks . Methods : In this Phase II , multicenter , investigator-blind , 4-week trial , adult patients with psoriasis vulgaris were r and omized to Cal/BD aerosol foam , Cal/BD ointment , aerosol foam vehicle or ointment vehicle ( 3:3:1:1 ) . The primary efficacy endpoint was the proportion of patients at week 4 who achieved treatment success ( clear or almost clear with at least a two-step improvement ) according to the physician ’s global assessment of disease severity . Results : In total , 376 patients were r and omized . At week 4 , significantly more patients using Cal/BD aerosol foam achieved treatment success ( 54.6 % versus 43.0 % [ ointment ] ; p = 0.025 ) ; mean modified ( excluding the head , which was not treated ) psoriasis area and severity index score was significantly different between Cal/BD aerosol foam and Cal/BD ointment ( mean difference –0.6 ; p = 0.005 ) . Rapid , continuous itch relief occurred with both active treatments . One adverse drug reaction was reported with Cal/BD aerosol foam ( application site itch ) . Conclusions : Cal/BD aerosol foam demonstrates significantly greater efficacy and similar tolerability compared with Cal/BD ointment for psoriasis treatment Background and Objective The antipsoriatic effect of an innovative aerosol foam formulation of fixed combination calcipotriol 50 μg/g ( as hydrate ; Cal ) and betamethasone 0.5 mg/g ( as dipropionate ; BD ) was explored in order to compare the effect with that of the first-line treatment Cal/BD ointment . Methods This was a Phase IIa , single-centre , investigator-blinded , exploratory study , with intra-individual comparison using a modified psoriasis plaque test . Patients were treated once daily ( 6 days/week ) for 4 weeks with Cal/BD foam , Cal/BD ointment , BD foam and Cal/BD foam vehicle , r and omized to four plaque test sites ( 5 cm2 each ) . The primary efficacy endpoint was change in total clinical score ( TCS ; sum of erythema , scaling and lesional thickness ) . Secondary endpoints included ultrasonographic changes in total skin thickness and echo-poor b and thickness , and adverse events . Results Twenty-four patients , median age 52.5 years ( range 21–75 ) , completed this study . At week 4 , test sites treated with Cal/BD foam had a significantly greater decrease in mean ( ±SD ) TCS ( −6.00 ± 1.27 ) versus those treated with Cal/BD ointment ( −5.25 ± 1.78 ; difference −0.75 ; 95 % CI −1.46 to −0.04 ; p = 0.038 ) , BD foam ( −4.96 ± 1.85 ; difference −1.04 ; 95 % CI −1.75 to −0.33 ; p = 0.005 ) or foam vehicle ( −1.88 ± 1.12 ; difference −4.13 ; 95 % CI −4.83 to −3.42 ; p < 0.001 ) . Total skin thickness and echo-poor b and thickness of Cal/BD foam-treated sites were reduced to a greater extent than those treated with comparators . Eleven patients reported 17 adverse events , the most frequent being headache ( five patients ) . There were no lesional/perilesional adverse events or adverse drug-related events . Conclusions Cal/BD foam demonstrated a significant improvement in antipsoriatic effect over Cal/BD ointment , BD foam and foam vehicle alone BACKGROUND Psoriasis is most often treated using topical therapies such as the once-daily fixed combination of calcipotriol and betamethasone dipropionate , which is available as a gel and an ointment . To date , there have been no direct comparisons of patient perspectives on the two formulations . OBJECTIVE To describe and compare patients ' perspectives on calcipotriol and betamethasone gel and ointment formulations , including real-life effectiveness , adherence behaviour , treatment satisfaction and health-related quality of life ( QoL ) , during long-term psoriasis vulgaris management , according to interim findings from the PRO-long study . METHODS PRO-long is a multicentre , prospect i ve , observational , 52-week cohort study in patients prescribed fixed-combination calcipotriol ( 50 μg/g ) and betamethasone ( 0.5 mg/g ; as dipropionate ) gel or ointment for long-term psoriasis management . Difference in effectiveness at 4 and 12 weeks was assessed by comparing the proportion of patients with controlled ( mild or very mild ) disease , according to the Patient 's Global Assessment . Additional patient question naires were used to assess adherence behaviour , treatment satisfaction ( nine-item Treatment Satisfaction Question naire for Medication ) and health-related QoL ( Skindex-29 ) . RESULTS A total of 156 patients were included in the analysis . In single items of the adherence behaviour and treatment satisfaction question naires , patients preferred the gel over the ointment as convenient , easy to use and fast to apply . Post hoc analysis demonstrated significant differences between gel and 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: IMPORTANCE Attempts to use topical cyclosporine in treatment of psoriasis have failed because of unfavorable physicochemical properties and inappropriate formulation design of the conventional dosage forms . OBJECTIVE To evaluate the efficacy of topical cyclosporine using liposomal nanocarriers ( lipogel ) in limited chronic plaque psoriasis . DESIGN , SETTING , AND , PARTICIPANTS A single-center r and omized clinical trial was conducted using a 3-arm parallel group , double-blind , vehicle and active comparator design and included 38 patients with chronic plaque psoriasis measuring less than or equal to 100 cm2 performed in a tertiary care hospital . INTERVENTIONS In the first arm , a total of 24 patients were r and omized to receive either cyclosporine lipogel , 2.0 % weight by weight ( w/w ) , or placebo lipogel . In the second arm , 7 patients were r and omized to receive cyclosporine lipogel , 2.0 % , or conventional cyclosporine cream , 2.0 % w/w . The third arm comprised 7 patients r and omized with cyclosporine lipogel , 2.0 % or st and ard clobetasol propionate cream , 0.05 % w/w . Patients were examined twice weekly for 14 weeks , or until total lesional clearance was observed , whichever was earlier . MAIN OUTCOMES AND MEASURES The primary outcome measure was the dermatological sum score ( DSS ) assessing erythema , scaling , and plaque elevation on a 4-point scale ( 0 , absent ; 1 , minimal ; 2 , moderate ; 3 , severe ) . RESULTS In 38 patients ( 23 men and 15 women with a mean [ SD ] age range from 35 [ 8 ] to 40 [ 13 ] years ) , a 19 % decrease in DSS score from a mean ( SD ) of 8.45 ( 0.67 ) to 6.82 ( 0.77 ) compared with baseline was observed after 2 weeks of treatment with cyclosporine lipogel , 2.0 % w/w ( P < .001 ; 95 % CI , 13.77 - 24.51 ) in 59 % of psoriasis lesional sites . At the end of the eighth week , a significant reduction ( approximately 83 % ) in DSS was seen in all sites treated with cyclosporine lipogel , ( P < .001 ; 95 % CI , 77.48 - 88.22 ) . At the end of the study period , complete clearance ( ie , DSS = 0 ) was observed in 16 ( 41 % ) psoriasis lesional sites treated with cyclosporine lipogel , 85.7 % of sites treated with clobetasol propionate cream , and none of the sites treated with conventional cyclosporine cream or placebo gel . CONCLUSIONS AND RELEVANCE Topical liposomal formulation of cyclosporine , 2.0 % w/w , is effective in treatment of limited chronic plaque psoriasis  with a satisfactory safety profile . Future clinical trials should assess liposomal cyclosporine in larger study population s. TRIAL REGISTRATION Clinical Trials Registry-India Identifier : CTRI/2011/12/002307 Abstract Background Fixed combination calcipotriol 50 μg/g ( Cal ) plus betamethasone 0.5 mg/g ( BD ) foam has been developed as a new treatment option for patients with psoriasis . Methods The r and omized , parallel‐group , investigator‐blinded Phase III , 12‐week PSO‐ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel .  Patients aged ≥18 years with mild‐to‐severe psoriasis were r and omized 4:4:1:1 to once‐daily Cal/BD foam , Cal/BD gel , foam vehicle or gel vehicle ( NCT02132936 ) . The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician 's global assessment of disease severity ( i.e. treatment success ) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel . Secondary efficacy endpoints included : proportion of patients achieving at least a 75 % reduction in modified psoriasis area and severity index ( mPASI75 ) , and time to treatment success ( TTTS ) . Safety was monitored throughout . Results A total of 463 patients were r and omized : Cal/BD foam ( n = 185 ) , Cal/BD gel ( n = 188 ) , foam vehicle ( n = 47 ) , gel vehicle ( n = 43 ) ; overall completion rate was 90 % . Cal/BD foam achieved higher treatment success rates ( 38 % vs. 22 % ; P < 0.001 ) and mPASI75 ( 52 % vs. 35 % ; P < 0.001 ) by week 4 than Cal/BD gel by week 8 . Median TTTS with Cal/BD foam was 6 weeks ; this could not be determined for Cal/BD gel as 50 % treatment success was not achieved ( P < 0.001 ) . Adverse drug reactions were reported in 14 ( 7.6 % ) Cal/BD aerosol foam patients and 7 ( 3.7 % ) Cal/BD gel patients ; all were single events except for itch with Cal/BD aerosol foam ( n = 5 ; 2.7 % ) and worsening psoriasis with Cal/BD gel ( n = 3 ; 1.6 % ) . Conclusion Cal/BD aerosol foam showed significantly greater efficacy after 4 weeks , than 8 weeks of treatment with Cal/BD gel , with similar tolerability Abstract Background Topical therapies are the mainstay of treatment for psoriasis vulgaris . The fixed combination of calcipotriol ( Cal ) 50 μg/g plus betamethasone 0.5 mg/g ( as dipropionate ; BD ) is a first‐line topical treatment and available as a gel or ointment . The use of these fixed combination products was compared in PRO‐long , a long‐term noninterventional study , for which interim results ( 4 and 12 weeks ) have previously been reported . Objective To describe and compare patients ’ perspectives on the fixed combination gel and ointment formulations ; to include efficacy , adherence behaviour , treatment satisfaction and health‐related quality of life ( HRQoL ) aspects during long‐term real‐life psoriasis management . Methods PRO‐long was a multicentre , prospect i ve , observational , 52‐week study of patients prescribed fixed combination Cal/BD gel or ointment in clinical practice . For final analysis the following were assessed at weeks 24 , 36 and 52 : differences in the proportion of patients with ‘ mild’/‘very mild ’ disease according to patient 's global assessment of disease severity , adherence behaviour , treatment satisfaction ( nine‐item treatment satisfaction question naire for medication ) and HRQoL ( Skindex‐29 ) . Results Patients ( n = 328 ) were prescribed once‐daily Cal/BD gel ( n = 152 ) or ointment ( n = 176 ) . At week 52 , a higher proportion of patients reported that the severity of their psoriasis was ‘ mild’/‘very mild ’ vs. baseline ( gel : 60.2 vs. 47.1 % ; ointment : 58.8 vs. 42.4 % ) , with greater treatment satisfaction reported in patients using gel vs. those using ointment . A higher proportion of patients found the gel ‘ easy ’ to use compared with the ointment ( 66.7 vs. 45.2 % ) . Daily application of treatment took ≤5 min for 86.1 % of patients using gel and 71.0 % of patients using ointment . Conclusion This real‐life study has demonstrated similar effectiveness between the Cal/BD formulations . However , over a 52‐week treatment period , patients reported greater treatment satisfaction with the gel , which was considered easier to use , faster to apply and overall a more convenient product Abstract Background : An aerosol foam formulation of fixed combination calcipotriene 0.005 % ( as hydrate ; Cal ) plus betamethasone dipropionate 0.064 % ( BD ) was developed to improve psoriasis treatment . Objectives : To compare the efficacy and safety of Cal/BD aerosol foam with Cal/BD ointment after 4 weeks . Methods : In this Phase II , multicenter , investigator-blind , 4-week trial , adult patients with psoriasis vulgaris were r and omized to Cal/BD aerosol foam , Cal/BD ointment , aerosol foam vehicle or ointment vehicle ( 3:3:1:1 ) . The primary efficacy endpoint was the proportion of patients at week 4 who achieved treatment success ( clear or almost clear with at least a two-step improvement ) according to the physician ’s global assessment of disease severity . Results : In total , 376 patients were r and omized . At week 4 , significantly more patients using Cal/BD aerosol foam achieved treatment success ( 54.6 % versus 43.0 % [ ointment ] ; p = 0.025 ) ; mean modified ( excluding the head , which was not treated ) psoriasis area and severity index score was significantly different between Cal/BD aerosol foam and Cal/BD ointment ( mean difference –0.6 ; p = 0.005 ) . Rapid , continuous itch relief occurred with both active treatments . One adverse drug reaction was reported with Cal/BD aerosol foam ( application site itch ) . Conclusions : Cal/BD aerosol foam demonstrates significantly greater efficacy and similar tolerability compared with Cal/BD ointment for psoriasis treatment Background and Objective The antipsoriatic effect of an innovative aerosol foam formulation of fixed combination calcipotriol 50 μg/g ( as hydrate ; Cal ) and betamethasone 0.5 mg/g ( as dipropionate ; BD ) was explored in order to compare the effect with that of the first-line treatment Cal/BD ointment . Methods This was a Phase IIa , single-centre , investigator-blinded , exploratory study , with intra-individual comparison using a modified psoriasis plaque test . Patients were treated once daily ( 6 days/week ) for 4 weeks with Cal/BD foam , Cal/BD ointment , BD foam and Cal/BD foam vehicle , r and omized to four plaque test sites ( 5 cm2 each ) . The primary efficacy endpoint was change in total clinical score ( TCS ; sum of erythema , scaling and lesional thickness ) . Secondary endpoints included ultrasonographic changes in total skin thickness and echo-poor b and thickness , and adverse events . Results Twenty-four patients , median age 52.5 years ( range 21–75 ) , completed this study . At week 4 , test sites treated with Cal/BD foam had a significantly greater decrease in mean ( ±SD ) TCS ( −6.00 ± 1.27 ) versus those treated with Cal/BD ointment ( −5.25 ± 1.78 ; difference −0.75 ; 95 % CI −1.46 to −0.04 ; p = 0.038 ) , BD foam ( −4.96 ± 1.85 ; difference −1.04 ; 95 % CI −1.75 to −0.33 ; p = 0.005 ) or foam vehicle ( −1.88 ± 1.12 ; difference −4.13 ; 95 % CI −4.83 to −3.42 ; p < 0.001 ) . Total skin thickness and echo-poor b and thickness of Cal/BD foam-treated sites were reduced to a greater extent than those treated with comparators . Eleven patients reported 17 adverse events , the most frequent being headache ( five patients ) . There were no lesional/perilesional adverse events or adverse drug-related events . Conclusions Cal/BD foam demonstrated a significant improvement in antipsoriatic effect over Cal/BD ointment , BD foam and foam vehicle alone BACKGROUND Psoriasis is most often treated using topical therapies such as the once-daily fixed combination of calcipotriol and betamethasone dipropionate , which is available as a gel and an ointment . To date , there have been no direct comparisons of patient perspectives on the two formulations . OBJECTIVE To describe and compare patients ' perspectives on calcipotriol and betamethasone gel and ointment formulations , including real-life effectiveness , adherence behaviour , treatment satisfaction and health-related quality of life ( QoL ) , during long-term psoriasis vulgaris management , according to interim findings from the PRO-long study . METHODS PRO-long is a multicentre , prospect i ve , observational , 52-week cohort study in patients prescribed fixed-combination calcipotriol ( 50 μg/g ) and betamethasone ( 0.5 mg/g ; as dipropionate ) gel or ointment for long-term psoriasis management . Difference in effectiveness at 4 and 12 weeks was assessed by comparing the proportion of patients with controlled ( mild or very mild ) disease , according to the Patient 's Global Assessment . Additional patient question naires were used to assess adherence behaviour , treatment satisfaction ( nine-item Treatment Satisfaction Question naire for Medication ) and health-related QoL ( Skindex-29 ) . RESULTS A total of 156 patients were included in the analysis . In single items of the adherence behaviour and treatment satisfaction question naires , patients preferred the gel over the ointment as convenient , easy to use and fast to apply . Post hoc analysis demonstrated significant differences between gel and 
    Output:
    