Enstilar® (calcipotriol + betamethasone)
Enstilar is a combination product containing calcipotriol and betamethasone for the treatment of psoriasis of the body and scalp. Enstilar is a cutaneous foam.
Enstilar is more effective than both placebo and treatment with either of the active substances alone. It has not been investigated if Enstilar is more effective than concurrent treatment with the two monoproducts. In the treatment of psoriasis of the body, Enstilar is more effective than corresponding combination products with an NNT of respectively 9 compared to ointment and respectively 6 compared to gel and does not cause more adverse reactions. Enstilar has not been compared to corresponding combination products in the treatment of psoriasis of the scalp. Generally, there is a lack of data describing efficacy and safety beyond 12 weeks of treatment.
The price of treatment of Enstilar is somewhat higher compared to similar combination products (e.g. Daivobet ointment) especially if the total consumption exceeds 60 grams. However, it is worth noting that the prices of both gel and ointment have fluctuated considerably lately. It would be possible to reduce the treatment price considerably by using a combination of the two monoproducts instead of a combination product like Enstilar, but it is unclear if it is possible to achieve the same effect as concurrent treatment with the two monoproducts because this has not been investigated.
It is IRF's overall assessment that Enstilar is a relevant treatment option for the treatment of psoriasis of the body requiring topical combination therapy, despite the potentially higher price of treatment. When it comes to treatment of psoriasis of the scalp, it is unclear if Enstilar is a relevant treatment option in patients requiring topical combination therapy. In relation to the treatment of psoriasis of the scalp, Enstilar ought therefore only to be considered for patients whose psoriasis of the scalp cannot be treated adequately with other combination products (e.g. Daivobet gel) or possibly a combination of monoproducts.