Ingenol mebutate gel (IMG) as topical treatment in patients with actinic keratosis (AK) lesions is well tolerated and is associated with positive cosmetic outcomes after 60 days, according to the results of a recent retrospective study published in the Journal of Dermatological Treatment.
Patients were treated with a daily application of IMG 150 μg/g over 3 days for lesions on the face and scalp, and lesions in other locations were treated for 2 days with the 500 μg/g formulation. A total of 260 treatments in 246 patients (mean age, 70.6±10.4) were evaluated. Dermatologists reported on the patient characteristics at baseline, as well as on the findings observed up to 60 days following treatment.
The patient population consisted of a majority of men (72.4%) with Fitzpatrick phototypes II and III. Overall, 56.7% of patients had a history of skin cancer. The presence of AK, which was observed in several different body locations, was found most often on the face. Prior to study entry, field-directed therapies were the most commonly used treatment alternatives.
Following treatment, clinically visible AK lesions in the treated areas decreased significantly from 6.16±3.02 (range, 1-18) to 1.22±2.02 (range, 0-17; P <.001), with an average reduction of 84%. Based on univariate analysis, significantly higher reduction rates were reported when IMG was applied to the face and scalp (P =.026) of women (P =.041) and of patients <age 70 (P =.033). Following multivariate analysis, the researchers found that advanced age was associated with significantly worse clearance rates (P =.038).
The investigators concluded that topical IMG was generally well tolerated, with patients experiencing positive cosmetic results after 60 days of use. Of note, women and patients younger than 70 tended to have better results.
Ortega Del Olmo R, Salido-Vallejo R. Ingenol mebutate for the treatment of actinic keratosis: effectiveness and safety in 246 patients treated in real-life clinical practice [published online September 28, 2017]. J Dermatolog Treat. doi:10.1080/09546634.2017.1386272