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In December 2014, the US Food and Drug Administration approved ivermectin cream 1% (Soolantra) for the treatment of inflammatory lesions of rosacea. This approval follows several safety and efficacy trials, particularly a phase 3 investigator-blinded, parallel-group study, published online in the British Journal of Dermatology on September 16, 2014, comparing once-daily application of ivermectin cream 1% and twice-daily metronidazole cream 0.75% in 962 patients with papulopustular rosacea over 16 weeks. Ivermectin showed more favorable local tolerability and significant reduction in lesion count versus metronidazole (83% vs 73.7%; P<.001) starting at week 3 and persisting throughout the study.
What’s the issue?
How many patients do you encounter each week who apply metronidazole topical treatments for years with little objective evidence of rosacea improvement? These data suggest that topical ivermectin may be a slightly more effective and tolerable alternative for papulopustular rosacea than the long-standing but modestly efficacious gold standard. With the recent approval of brimonidine gel for the erythematous component of rosacea, it is groundbreaking to introduce novel topical mechanisms into our rosacea prescription armamentarium as we attempt to elucidate the disease’s complex pathophysiology. What is your experience with this topical, and how do you think it will fit into your prescribing routines for rosacea?
In December 2014, the US Food and Drug Administration approved ivermectin cream 1% (Soolantra) for the treatment of inflammatory lesions of rosacea. This approval follows several safety and efficacy trials, particularly a phase 3 investigator-blinded, parallel-group study, published online in the British Journal of Dermatology on September 16, 2014, comparing once-daily application of ivermectin cream 1% and twice-daily metronidazole cream 0.75% in 962 patients with papulopustular rosacea over 16 weeks. Ivermectin showed more favorable local tolerability and significant reduction in lesion count versus metronidazole (83% vs 73.7%; P<.001) starting at week 3 and persisting throughout the study.
What’s the issue?
How many patients do you encounter each week who apply metronidazole topical treatments for years with little objective evidence of rosacea improvement? These data suggest that topical ivermectin may be a slightly more effective and tolerable alternative for papulopustular rosacea than the long-standing but modestly efficacious gold standard. With the recent approval of brimonidine gel for the erythematous component of rosacea, it is groundbreaking to introduce novel topical mechanisms into our rosacea prescription armamentarium as we attempt to elucidate the disease’s complex pathophysiology. What is your experience with this topical, and how do you think it will fit into your prescribing routines for rosacea?
In December 2014, the US Food and Drug Administration approved ivermectin cream 1% (Soolantra) for the treatment of inflammatory lesions of rosacea. This approval follows several safety and efficacy trials, particularly a phase 3 investigator-blinded, parallel-group study, published online in the British Journal of Dermatology on September 16, 2014, comparing once-daily application of ivermectin cream 1% and twice-daily metronidazole cream 0.75% in 962 patients with papulopustular rosacea over 16 weeks. Ivermectin showed more favorable local tolerability and significant reduction in lesion count versus metronidazole (83% vs 73.7%; P<.001) starting at week 3 and persisting throughout the study.
What’s the issue?
How many patients do you encounter each week who apply metronidazole topical treatments for years with little objective evidence of rosacea improvement? These data suggest that topical ivermectin may be a slightly more effective and tolerable alternative for papulopustular rosacea than the long-standing but modestly efficacious gold standard. With the recent approval of brimonidine gel for the erythematous component of rosacea, it is groundbreaking to introduce novel topical mechanisms into our rosacea prescription armamentarium as we attempt to elucidate the disease’s complex pathophysiology. What is your experience with this topical, and how do you think it will fit into your prescribing routines for rosacea?
