There has been a lot of copy written about so-called low dose or anti-inflammatory dose doxycycline. This form of antibiotic therapy is one of the more promising recent therapeutic developments ; it will likely become a widely known and available treatment.
This recently published paper shows that a daily dose of 40mg of doxycycline is as effective in reducing the lesions of rosacea as a higher dose of 100mg or 200mg a day.
Note that this is a statistical study using existing clinical trial data, and that the authors work for Collagenex who make Oracea.
Anti-Inflammatory Dose Doxycycline (40 mg Controlled-Release) Confers Maximum Anti-Inflammatory Efficacy in Rosacea.
Skinmed. 2007 Sep-Oct;6(5):221-6., Theobald K, Bradshaw M, Leyden J., CollaGenex Pharmaceuticals Inc, Newtown, PA.Background. Two large clinical trials have recently demonstrated the efficacy of a 40-mg controlled-release formulation of doxycycline in the treatment of rosacea, a dose well below the conventional level of 100 to 200 mg/d. Since no formal dose-response studies have been conducted, the authors analyzed phase 3 data to determine whether a dose-efficacy relationship exists.
Methods. Standard parametric regression analyses were used to estimate the correlations between dose (mg/kg body weight) and overall drug exposure (area under the curve [AUC]) in a phase 1 pharmacokinetic study and between dose and efficacy (mean change from baseline in total inflammatory lesion count at week 16) in 2 pooled phase 3 clinical efficacy studies. Additional regressions were run at each visit for the clinical efficacy studies to determine whether results differed across visits. A regression analysis was also performed in a subset of patients who showed a greater efficacy response.
Results. We found overall drug exposure (AUC) to have a highly significant correlation with dose (mg/kg) (r=0.49; P=.006). In contrast, clinical efficacy did not correlate with dose at any of the visits at week 3 (r=0.01; P=.85), week 6 (r=0.04; P=.53), week 12 (r<0.01; P=.98), and week 16 (r=0.03; P=.64) or among the subset of patients who showed greater clinical benefit.
Conclusions. Higher mg/kg doses led to higher plasma concentrations but did not lead to increased clinical efficacy. Anti-inflammatory dose doxycycline (40-mg controlled-release formulation) conferred peak anti-inflammatory efficacy in the treatment of rosacea.
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2 comments ↓
I am a rosacea sufferer. I immigrated from South Africa to Australia In SAfrica i uses Tetralysal which was very effective for the condition. In Austalia the docters prescribed doxycyline 50 mg a day. It doesn’t work at all. I need to fly back to SAfrica every year to get the medicine there. I am desperate to find a less costly solution in Australia as doxycycline seems ineffective.
Hi Ludi,
Doxycycline works well for the papules and pustules of rosacea, is that what you are taking it for ? It is a tetracycline, like I imagine Tetralysal is also. At 50mg a day I would expect it to take up to 6 weeks to see a benefit. The advantage of such a small dose is that it won’t likely give some of the other side effects of higher doses.
davidp.
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