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Is Enstilar Foam used to treat plaque psoriasis?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on April 19, 2023.

Official answer

by Drugs.com

Yes, Enstilar is a topical spray foam applied to the skin to treat plaque psoriasis. It contains calcipotriene, a vitamin D analog, and betamethasone dipropionate, a potent corticosteroid. Enstilar is used on the skin for up to 4 weeks in people 12 years and older.

Plaque psoriasis is a long-term skin condition often found on the elbows, knees, scalp and lower back. Psoriasis is characterized by inflamed, red lesions with a silvery white scale. The raised areas may itch, burn or bleed. The exact cause of psoriasis is not known, but symptoms can usually be well-managed with treatment.

Enstilar Foam 0.005% / 0.064% contains 50 mcg of calcipotriene and 0.643 mg of betamethasone dipropionate per gram. It is manufactured by LEO Laboratories Ltd.

How do I apply Enstilar Foam?

Apply to the skin once daily for up to 4 weeks, but if your skin clears sooner, treatment may be discontinued. Follow your healthcare provider’s instructions and read the Instructions For Use that come with Enstilar Foam.

To apply:

  • Wash your hands and shake the bottle before use.
  • Hold the can about 1 and 1/2 inches from the affected area. ​​To spray, push down on the nozzle.
  • Gently rub the foam into your skin areas to be treated. Repeat the steps above for other affected areas as instructed by your healthcare provider.
  • Wash your hands after using Enstilar Foam (unless you are using the medicine to treat your hands).

Do NOT:

  • use more than 60 grams of Enstilar Foam every 4 days.
  • use with occlusive dressings (like a bandage or wrap) unless directed by a healthcare provider
  • use on the face, groin, or axillae (underarms), or if skin atrophy (skin thinning) is present at the treatment site.
  • get Enstilar Foam near or in your mouth, eyes or vagina.

How does Enstilar Foam work?

Although the exact mechanism is not fully known, calcipotriene, a topical vitamin D analog in Enstilar Foam, is thought to help to slow down the overproduction of skin cells commonly seen in psoriasis. Corticosteroids, like betamethasone dipropionate, help to reduce inflammation, redness, itching and pain.

Learn more: Psoriasis: Pictures, Symptoms and Drug Treatment Options

How well does Enstilar Foam work for plaque psoriasis?

Enstilar Foam has been shown to be effective using a 5-point Investigator’s Global Assessment (IGA) in short-term (4 week) studies and longer-term 52-week studies.

  • In clinical studies, Enstilar Foam was compared in people using the vehicle alone or using the individual active ingredients.
  • After 4 weeks of once-daily treatment, 53.3% of patients using Enstilar Foam showed a result of “clear or almost clear” skin.
  • In long-term 52-week studies, after initial clearing of skin with 4 weeks of treatment, Enstilar Foam applied twice-a-week prolonged the time the treatment worked (56 days for Enstilar Foam vs. 30 days for vehicle foam).

Studies

The effectiveness of Enstilar spray foam applied once-daily was evaluated in a clinical study with over 420 adult patients with psoriasis. It was compared to the vehicle alone (foam that contains no active medicine).

  • The effectiveness was determined using a 5-point Investigator’s Global Assessment (IGA) at Week 4.
  • Treatment success was defined as the percentage of patients who reached an IGA score of at least a 2-step improvement from baseline and equating to skin of “clear” or “almost clear”.
  • Most patients had a disease severity of “moderate”. Patients with "mild" disease were required to be "clear" to be considered a treatment success.

Related Questions

Skin improvements

After 4 weeks of treatment, 53.3% of patients using Enstilar Foam showed a result of “clear or almost clear” skin (and a 2-grade improvement in skin symptoms) compared to 4.8% for the vehicle control group, a significant effect. In addition, more than 26% of patients had skin that was “clear or almost clear” after 2 weeks, compared to 1.9% with the vehicle only.

In another study, Enstilar Foam applied once-daily was compared to the two active ingredients alone: betamethasone in vehicle and calcipotriene in vehicle. After 4 weeks, 45% of patients using Enstilar Foam showed a result of “clear or almost clear” skin (and a 2-step improvement in skin symptoms) compared to 30.7% for the betamethasone group and 14.9% for the calcipotriene group.

Long-term data

Patients who had achieved success in 4-week studies with the use of Enstilar Foam continued in a long-term treatment study for up to 52 additional weeks. Researchers looked at long-term treatment success at over 520 people using Enstilar Foam or vehicle foam. Patients applied the foam twice weekly (but not on consecutive days) up to 52 additional weeks.

Long-term use with Enstilar Foam twice weekly was more effective than the foam vehicle by:

  • prolonging the time the treatment worked (a median time to loss of response of 56 days for Enstilar Foam vs. 30 days for vehicle foam)
  • increasing the number of patients who achieved a skin result of “clear or almost clear”
  • reducing the number of people who loss their response over long-term use (subjects in the Enstilar Foam twice weekly group experienced loss of response a median of 2 times compared to 3 times for subjects in the vehicle foam twice weekly group)

Common side effects with Enstilar Foam may include application site irritation, application site itching, folliculitis, changes in skin color, hypercalcemia (high calcium levels), hives, and worsening of psoriasis.

Related: Enstilar Foam side effects and warnings (in more detail)

This is not all the information you need to know about Enstilar Foam (betamethasone and calcipotriene topical) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

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