Sernivo: It’s all in the vehicle

The active drug in the newly approved psoriasis spray treatment Sernivo (betamethasone dipropionate, Promius Pharma) isn’t new. What is making news is Sernivo’s vehicle, according to Linda Stein Gold, M.D., director of dermatology clinical research and a division head of dermatology at the Henry Ford Hospital, in Detroit, Mich., and Promius Pharma consultant.

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Dr. Stein Gold presented on topical therapies for psoriasis, including Sernivo, at the American Academy of Dermatology’s 74th Annual Meeting in Washington, D.C., in March 2016. She says the vehicle allows penetration into the skin but not rapid penetration through the skin and into systemic circulation.

“It has good dermal and epidermal penetration but the penetration into the system was very low,” Dr. Stein Gold says.

Data from the drug’s vasoconstriction assay suggest Sernivo is a mid-potency-possible a class III or IV-drug. Vasoconstriction test correlates with clinical psoriasis activity, which makes it a relevant measure of topical corticosteroid potency, according to Dr. Stein Gold.

“But what is interesting is when we test it against a drug that appears to have a much stronger efficacy based on the skin blanching (a class II drug), we found that [Sernivo] is actually equally as efficacious,” she says.

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Dr. Stein Gold presented findings at the January 2016 Winter Clinical in Koloa, Hawaii, in which she showed a head-to-head comparison of betamethasone dipropionate to higher potency augmented betamethasone dipropionate.

“We showed in this study that the spray really is comparable. This sophisticated vehicle technology has allowed a mid-potency steroid to act like a more potent steroid in actual clinical practice,” she says.

The dermatologist says she thinks Sernivo is appropriate for patients who have plaque psoriasis as a treatment by itself or in combination with a topical vitamin D analog. Physicians might also use it to treat resistant plaques on psoriasis patients taking biologic, or systemic, therapy.

Sernivo shouldn’t be used on the face or any of the skin folds.

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“Generally, I like to get patients under control with a topical steroid and, then, use Sernivo more as a maintenance therapy for the long term,” Dr. Stein Gold says.

For more on Sernivo’s FDA approval.