Skip to main content

A multicenter study of topical azelaic acid 15% gel in combination with oral doxycycline as initial therapy and azelaic acid 15% gel as maintenance monotherapy.

J Drugs Dermatol. 2009 Jul; 8(7): 639-48Thiboutot DM, Fleischer AB, Del Rosso JQ, Rich PThis two-phase, multicenter study was undertaken to examine the safety and efficacy of combination therapy with oral doxycycline and topical azelaic acid (AzA) 15% gel in moderate-to-severe papulopustular rosacea and to determine the effect of subsequent maintenance monotherapy with AzA 15% gel alone. In the initial open-label, non-randomized phase of the study, subjects (n=172) received topical AzA 15% gel and oral doxycycline (100 mg), both twice daily, for < or = 12 weeks. In the second, double-blind study phase, subjects who had initially undergone at least four weeks of combination treatment in phase 1 and who achieved > or = 75% inflammatory lesion count reduction (n=136) were randomized to receive either AzA 15% gel or its vehicle twice daily for an additional 24 weeks. Assessments of efficacy were obtained at four-week intervals throughout both phases of the study and included change in inflammatory lesion count, investigator global assessment (IGA) of rosacea severity, and separate assessments of erythema and telangiectasia severity. At the last visit for each phase of the study, the investigator and participant each rated overall improvement, with the participant rating cosmetic acceptability and the investigator rating treatment as "success" or "failure" based on IGA score. During the second phase of the trial, the rate of relapse -- defined as either a 50% deterioration in the lesion count improvement from phase 1, an increase in erythema intolerable to the subject or maintenance therapy failure as judged by the investigator and/or the subject -- was obtained. Safety assessments were conducted for both phases of the study and included analysis of adverse events (AEs) and a rating of cutaneous tolerability by the subject. By week 12 of the open-label phase of the study, 81.4% of subjects had reached a 75% or greater reduction in inflammatory lesion count, and 64% of patients achieved treatment success. During the second study phase (maintenance phase), AzA 15% gel consistently provided a better maintenance response than vehicle, with maintenance of remission in 75% of patients over the six-month duration of the maintenance phase. Additionally AzA 15% gel showed a statistically significantly lower deterioration in absolute inflammatory lesion counts than did vehicle after 8, 16, 20 and 24 weeks of maintenance therapy. No serious treatment-related AEs were encountered in the study, and 98.5% of subjects were satisfied with the local tolerability of both AzA gel and vehicle.

Popular posts from this blog

Prevalence Of And Associated Factors For Dry Eye In A Spanish adult population

To estimate the prevalence of dry eye and to investigate its relationship with lifestyle and systemic factors in a general adult population in north-western Spain. METHODS: A dry eye questionnaire was administered and objective tests were performed in 654 individuals [mean age (Standard deviation): 63.6 (14.4) years, range: 40-96, 37.2% males]. Subjects were considered symptomatic when one or more of the symptoms of the questionnaire were present often or all the time. Schirmer test or= 3 and fluorescein staining >or= 1 were considered indicative of signs. Dry eye was defined as the simultaneous presence of symptoms and at least one sign. A design based analysis was performed and all calculations were weighted to give unbiased estimates. RESULTS: Dry eye prevalence was 11.0% (95%confidence interval [CI] 8.6-13.3). Dry eye was found to be more frequent in women (11.9%, 95%CI 8.8-15.1) than in men (9.0%, 95%CI 5.3-12.6), and was significantly associated with aging (p autoimmune diseas...
Read more

Treatments For Rosacea

The specific treatments for rosacea is determined by your physician based on: Your age, general health and medical history. How advanced is the eruption. Tolerance to specific medications, procedures or therapies. Their expectations for the trajectory of the eruption. Your opinion or preference. Treatments for rosacea may include : Modifications to diet Antibiotics. Cortisone ointment. Laser surgery Use sunscreen with a sun protection factor Currently there are several treatments for rosacea are used, depending on the events that it has. At the initial stage, to prevent the dilation of blood vessels and the consequent need to avoid red hot environments, exposure to sunlight, extreme changes in temperature and food hot or too much seasoning. When pustules that resemble pimples, prescribed oral antibiotics such as tetracycline. Another alternative treatments for rosacea is the topical antibiotics such as metronidazole. Also is using retinoids, which regulate the sebum production of the ...
Read more

ATPgammaS enhances the production of inflammatory mediators

Adenosine 5'-triphosphate (ATP) affects multiple intra- and extracellular processes, including vascular tone and immune responses. Microvascular endothelial cells (EC) play a central role in inflammation by recruitment of inflammatory cells from blood to tissues. We hypothesized that ATP (secreted by neurons and/or released after perturbation of cutaneous cells) may influence secretion of inflammatory messengers by dermal microvascular EC through actions on purinergic P2 receptors. Addition of the hydrolysis-resistant ATP analogue, adenosine 5'-O-(3-thiotriphosphate) (ATPgammaS), to subconfluent cultures of the human microvascular endothelial cell-1 (HMEC-1) cell line led to a dose- and time-dependent increase in release of IL-6, IL-8, monocyte chemoattractant protein-1, and growth-regulated oncogene alpha. Both ATPgammaS-induced release and basal production of these proteins were significantly inhibited by the purinergic antagonists pyridoxal-5'-phosphate-6-azophenyl-2...
Read more