Combo helps achieve faster skin clearance in rosacea patients

New Delhi: Addition of 40 mg doxycycline modified-release capsules (DMR) to daily ivermectin 1% cream produces faster responses and increases satisfaction in patients with severe rosacea compared to using 1% ivermectin alone, finds a recent study published in the Journal of the American Academy of Dermatology.

Rosacea, also called acne rosacea, is a common skin condition that causes redness and often small, red, pus-filled bumps on the face. For patients with moderate to severe rosacea, combination therapy with oral and topical agents has become a common treatment option. Combination therapy might be preferable to monotherapies in simultaneously treating different rosacea features. However, there is a lack of data on combination therapies for rosacea treatment.

Martin Schaller, from Tübingen University Hospital in Germany, and colleagues evaluated the efficacy and safety of combining ivermectin 1% cream (IVM) and doxycycline 40 mg modified-release capsules (DMR) versus IVM and placebo (PBO) for treatment of severe rosacea.

For the purpose, they conducted a 12-week multicenter, randomized comparative trial involving adults with severe rosacea, 273 participants were randomly assigned to receive o IVM and DMR (combination arm) and IVM and placebo (monotherapy).

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Key findings of the study include:

• IVM and DMR exhibited superior efficacy in reducing inflammatory lesions compared with monotherapy (−80.3 versus −73.6 percent) and in the Investigator's Global Assessment (IGA) score.


• As of week 4, combination therapy had a faster onset of action; at week 12, significantly more patients achieved IGA 0 (11.9 versus 5.1 percent) and 100 percent lesion reduction (17.8 versus 7.2 percent) with combination therapy.


• The Clinician's Erythema Assessment score, stinging/burning, flushing episodes, Dermatology Life Quality Index, and ocular signs/symptoms were reduced with both treatments, and both treatments were well-tolerated.

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"Our study results suggest that the combination therapy of IVM and DMR when followed with a proper skin care regime improve treatment results in rosacea patients. We observed a faster onset of visible improvement, greater efficacy, a reduction in flushing episodes, and a decrease in facial stinging and burning following the combo treatment. This offers the opportunity to reach skin clearance in more patients while not compromising on safety. Overall, patient satisfaction was achieved more frequently in those subjects who utilized the combination therapy," concluded the authors.

To read the full study log on to https://doi.org/10.1016/j.jaad.2019.05.063