In patients with rosacea, those with more severe disease were more adherent to self-applied topical medication than those with less severe disease although overall poor adherence was typical, according to study findings published in the Journal of the American Academy of Dermatology. Those with more severe disease showed greater improvement after 3 months of treatment compared with those with less severe disease.
Researchers sought to investigate a possible correlation between rosacea severity and topical medication adherence. To accomplish this, they conducted a prospective single-center study that included 30 adults (mean age, 62 years; 93% White; 70% women) diagnosed with rosacea, recruited from the Atrium Health Wake Forest Baptist Department of Dermatology clinics and given ivermectin cream 1% for once daily use for 3 months. Adherence was measured by an electronic cap that recorded time and date of each use. The Investigator’s Global Assessment of Rosacea (IGA, 0-4) was used to assess severity (0 = clear; 1 = almost clear; 2 = mild; 3 = moderate; 4 = severe; stratified by IGA ≤ 2 [n=13], or IGA ≥ 3 [n=14]) in all, 2 patients were lost to follow-up, and 1 patient lost to protocol failure.
Baseline mean IGA was 2.4, and 1.3 at 3-month follow-up (P <.00001). There was 62% mean adherence across the study period (month 1: 78%; month 2: 57%; month 3: 49%). The lowest (48%) adherence was seen in those with least severe disease at baseline vs 73% adherence in those with more severe disease at baseline (P =.02). Those with more severe disease were consistently more adherent (month 1: 77%; month 2: 69%; month 3: 70%), vs those with less severe disease (78%, 45%, 27%, respectively; P =.002). The IGA score mean change was more significant in those with more severe disease (-1.61) vs those with less severe disease (-0.50; P =.002).
Researchers concluded that patients “with more severe disease were more adherent” compared with patients with milder disease.” They continued, “However, poor adherence (< 80%) was common, even in [patients] with severe disease.” Those with more severe disease improved more with treatment than those with less severe disease.
Perche PO, Singh R, Cook MK, et al. Greater rosacea severity correlates with greater adherence and improvement in a clinical study. J Am Acad Dermatol. Published online April 28, 2022. doi:10.1016/j.jaad.2022.04.037