# Design of an Emulgel for Psoriasis Focused on Patient Preferences  
[PERSON]  
1 Biomedical Research Centre CEBMED/Research Centre of the Fernando Pessoa Energy, Environment and Health Research Unit FP-ENAS, Faculty of Health Sciences, University of Fernando Pessoa, 4249-004 Porto, Portugal; [EMAIL_ADDRESS]  
[PERSON]  
2 UCIBIO/REQUIMATE, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; [EMAIL_ADDRESS] (D.F.d.S.); up2 UCIO6484@gbpt (S.M.); [EMAIL_ADDRESS] (J.M.S.L.)  
[PERSON]  
on the physical, functional, and psychological impacts of a treatment [7]. Incorporating patient preferences into the design of pharmaceutical drug products may enhance treatment adherence and optimize outcomes. Several studies aimed at understanding patient preferences regarding topical anti-sporiatic medicines are available in the literature [8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20; 21], but only a limited number focused on the sensory attributes [9; 18; 19; 22]. In general, low residue, minimum ability to stain clothes, low stickiness and good moisturizing properties are considered positive attributes [9]. Based on these attributes, other approaches have recently been developed, to the detriment of classic oily vehicles, such as hydrogel [10], foam [11], or cream [12].  
Betamethasone dipropionate (BD) is a potent glucocorticoid, frequently used in the treatment of inflammatory skin disorders such as psoriasis. Several topical commercial formulations containing this drug are available, namely ointments, creams, and solutions, but no gel or vehicle with an external gelled phase (such as the emulgel) are on the market. In fact, a study reported that 82% of physicians thought that adherence could be markedly improved if psoriasis patients could use a non-alcoholic gel. Offering a BD aqueous gel could thus represent a relevant contribution to the improvement of patient satisfaction with anti-inflammatory topical treatments, especially in chronic diseases such as psoriasis. This is, however, technically challenging due to the high lipophilicity and low aqueous solubility of BD. Cyclodext (CDs) are cyclic oligosaccharides that have been recognized as promising pharmaceutical adjuvants due to their unique ability to form water-soluble inclusion complexes with various poorly soluble compounds. CDs are widely used in pharmaceuticals, drug delivery systems, cosmetics, and in the food and chemical industries due to their potential to enhance the aqueous solubility and dissolution rate of drugs; they also protect drugs from heat, light, hydrolysis, and oxidation, thereby improving the formulation stability [23]. An emulgel has the characteristics of both emulsions (with two immiscible phases) and hydrogels (with an aqueous phase gelled with a gelling agent) and promotes the stability of simple emulsions while maintaining their permeation and emollient characteristics [24].  
The purpose of this study was to develop a new topical formulation containing BD with improved characteristics, focusing on patient preferences. Two vehicles with an aqueous external phase were explored: an emulgel and a hydrogel based on a CD inclusion complex. With both vehicles having an external gelled aqueous phase, they are expected to present improved sensory properties such as being greaseless, non-staining, and having better spreadability.  
The TPP for BD vehicles for psoriasis treatment was established based on minimum residue, fast absorption, allowing the patient to dress shortly after applying the medicine, reduced staining of clothes, and moisturizing properties.