Ivermectin tops metronidazole for papulopustular rosacea

(HealthDay)—For patients with papulopustular rosacea (PPR), once-daily ivermectin 1 percent cream (IVM 1 percent) is superior to twice-daily metronidazole (MTZ 0.75 percent) cream, according to a study published in the April issue of the British Journal of Dermatology.

Alain Taieb, M.D., Ph.D., from Hôpital Saint-André in Bordeaux, France, and colleagues conducted a phase 3 randomized trial involving patients with PPR. Participants were randomized to receive once-daily IVM 1 percent cream (478 participants) or twice-daily MTZ 0.75 percent cream (484 participants) for 16 weeks. Inflammatory lesion counts and Investigator's Global Assessment (IGA) were used to assess efficacy.

The researchers found that IVM 1 percent was significantly superior to MTZ 0.75 percent at week 16 in terms of reduction in inflammatory lesions from baseline (83.0 versus 73.7 percent; P < 0.001). This superiority was observed as early as week three. IVM 1 percent was also superior in terms of IGA results (subjects 'clear' or 'almost clear') (84.9 versus 75.4 percent; P < 0.001). Comparable adverse event incidence was seen between the groups; local tolerability was superior for IVM 1 percent. Global improvement was rated as 'excellent' or 'good' by more patients receiving IVM.

"In conclusion, while MTZ 0.75 percent cream has been the standard treatment for the papulopustular lesions of rosacea, its efficacy is now surpassed by that of IVM along with the advantage of once-daily dosing and high patient satisfaction," the authors write.

Two authors disclosed financial ties to Galderma R&D, which manufactures ivermectin and funded the study.

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