Comparison of Refined and Crude Indigo Naturalis Ointment in Treating Psoriasis

Phase 2

Completed

Interventions: Drug: refined indigo naturalis ointment
Drug: crude indigo naturalis ointment

Brief Summary: To compare the efficacy and safety of refined indigo naturalis ointment with that of crude ointment in treating psoriasis.

Detailed Description: Our previous studies have shown that topical application of indigo naturalis significantly improves psoriatic symptoms. However, patient compliance is hindered because the preparation is unsightly and stains clothing.

To improve patient compliance, we have developed a refined formulation in which closer to natural skin tones and less prone to stain clothing. In this study, we evaluated the efficacy and safety of this refined form of oil extract ointment and compared the results with those of the original crude form of indigo naturalis ointment in treating psoriasis.

Recruitment & Eligibility

Inclusion Criteria

Patients were had received a diagnosis of plaque psoriasis based on clinical assessment by two dermatologists at least a one year prior to entry into the study;
Patients had mild to moderate plaque psoriasis with bilateral symmetric lesions; were adults aged 20 to 65 years;
Patients were in good general health.
Female patients of childbearing age agreed to continue using birth control measures for the duration of the study.

Exclusion Criteria

Patients had non-plaque (i.e., pustular, guttate, or erythrodermic) or drug-induced forms of psoriasis; total body surface involvement of more than 60%;
Patients had a history of allergy to indigo naturalis.
Patients were excluded if they have received systemic therapy within 4 weeks before enrollment, phototherapy within 3 weeks, or used topical psoriasis agents within 2 weeks before enrollment.
Patients had included usage of medications that affect psoriasis during the study and unwillingness to comply with study protocol.

Arm && Interventions

Group	Intervention	Description
refined indigo naturalis ointment	refined indigo naturalis ointment	Refined indigo naturalis ointment was applied topically to one of 2 bilaterally symmetrical psoriatic plaque lesions of the same patient for 8 weeks, starting on the date of enrollment in the study
crude indigo naturalis ointment	crude indigo naturalis ointment	Crude indigo naturalis ointment was applied topically to one of 2 bilaterally symmetrical psoriatic plaque lesions of the same patient for 8 weeks, starting on the date of enrollment in the study

Primary Outcome Measures

Name	Time	Method
Change From Baseline in Psoriasis Severity Idex(PSI) at Week 8.	Baseline and Week 8	The PSI score is comprised of the grading for scaling, erythema, and induration on a 5-point scale (where 0=absent, 1=mild, 2=moderate, 3=severe and 4=very severe) and the sum of these three items with a minimal score of 0 and a maximum of score of 12. Higher values represent a worse outcome. For expample, a highter PSI score at baseline and lower PSI score after treatment represent an improvement.
Clearing Percentage of Target Plaque Area	Baseline and Week 8	The target plaque area was rated from 0% to 100% (0%=clearance after treatment and 100%=baseline before treatment). Higher values represent a worse outcome. For expample, a lower percentage after treatment represent an improvement.
Percentage Improvement Compared to Baseline in the Target Plaque.	Baseline and Week 8	The improvement percentage of the target plaque at the follow-up visit was calculated as: \[(Area of baseline plaque\PSI of baseline plaque - Area of plaque week 8\PSI of plaque week 8)/(Area of baseline plaque\PSI of baseline plaque)\]\100%. Higher values represent a better outcome. For expample, a higher percent represents an improvement.

Secondary Outcome Measures

Name	Time	Method
Patients' Rating of the Overall Improvement at Week 8	Baseline and Week 8	At week 8, patients rated an overall response to treatment (separately for each side of the body), taking into account both the extent and the degree of the disease, compared with the pretreatment condition, on a 6-point scale (0=worse,1=poor, 2=fair, 3=good, 4=excellent, 5=cleared). A score of 4 or higher represents a better outcome.
Patients Preferred Ointment Type.	Week 8	At the end of the trial, the patients were asked which ointment they preferred.