Topical Ivermectin Most Effective, Improves QoL in Patients With Rosacea

Avatar photoVirginia A. Schad, PharmD, RPh
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Rosacea has been reported to share genetic risk loci with CD and other autoimmune disorders.10 Several studies have shown a higher prevalence of CD among individuals with rosacea, although the correlation appears strongest in women, with one large Danish population-based control study reporting an odds ratio of 2.03 (95% CI, 1.35-3.07) in women and the association not reaching statistical significance in men.2,11 The study did not examine rosacea subtypes; thus, it is unclear whether the risk spans all subtypes. Nevertheless, based on their data, the Danish investigators suggested there may be benefit to asking patients with rosacea about their personal and family history of autoimmune diseases and potentially screening them for CD.11

Rosacea has been reported to share genetic risk loci with CD and other autoimmune disorders.10 Several studies have shown a higher prevalence of CD among individuals with rosacea, although the correlation appears strongest in women, with one large Danish population-based control study reporting an odds ratio of 2.03 (95% CI, 1.35-3.07) in women and the association not reaching statistical significance in men.2,11 The study did not examine rosacea subtypes; thus, it is unclear whether the risk spans all subtypes. Nevertheless, based on their data, the Danish investigators suggested there may be benefit to asking patients with rosacea about their personal and family history of autoimmune diseases and potentially screening them for CD.11

Compelling evidence supports IVM 1% cream as an effective topical treatment for papulopustular rosacea, that improves QoL over time.

Ivermectin (IVM) 1% cream appears to be the most effective topical treatment for papulopustular rosacea (PPR) with sustained improvement in quality of life (QoL) over time, according to study research published in Dermatologic Therapy.

Researchers critically reviewed and appraised the efficacy of topical IVM 1% in PPR and its effect on patients’ QoL, including psychological, physical, and social benefits, against other topical treatment options. After a search of the literature using PubMed, MEDLINE, EMBASE, Cochrane, and ClinicalTrials.gov, 6 studies from 4 published articles were included in a meta-analysis that demonstrated that more patients achieved “success” (Investigator Global Assessment, ≤1) and “complete clearance” (Investigator Global Assessment, 0) with IVM 1% compared with metronidazole, azelaic acid, and placebo. In addition, the rate of participants achieving a lower Dermatology Life Quality Index score, and thus a better QoL, both short- and long-term, was higher with IVM 1%.

One of the limitations of this analysis is that insufficient long-term efficacy data prevented the investigators from addressing the long-term efficacy of IVM 1% vs other treatments.

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The authors concluded that, “This meta-analysis gives strong evidence that IVM 1% cream is the most effective topical treatment above other alternatives and it satisfies the impairment of social and working life with a sustained better QoL.” They added that additional studies “confirming and extending this period of remission are warranted, as well as researches investigating the potential use of this agent in combination with other agents.”

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Reference

Husein-ElAhmed H, Steinhoff M. Efficacy of topical ivermectin and impact on quality of life in patients with papulopustular rosacea: A systematic review and meta-analysis [published on December 20, 2019]. Dermatol Ther. doi:10.1111/dth.13203

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