3% Praziquantel (PZQ) for the redness of rosacea

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This recent paper from International Journal of Dermatology introduces us to the compound known as Praziquantel. We learn that this active can be formulated into a 3% topical which shows antimicrobial activity. Praziquantel, also known as Biltricide, has been used orally for the treatment of parasitic worms. This trial is the first reported use of Praziquantel topcially.

The study found encouraging results – 3% topical Praziquantel was able to clear the redness of rosacea and improve the overall quality of life of participants.

41 patients had erythematotelangiectatic rosacea, and 24 had papulopustular rosacea. The topical was found to be well tolerated with no participants dropping out due to lack of efficacy or adverse events. The topical was formulated as follows

Each 100 g of PZQ ointment contained 3 g of PZQ, 17 g of polyethylene glycol-400, 30 g of poloxamer-268, and 50 g of propylene glycol.

The PZQ ointment was prepared by the fusion method in the Department of Drug Chemistry and Technologies at Zaporozhye State Medical University.

 Why Praziquantel?

Here is the motivation to conduct this study, quoted from the authors:

We have observed that praziquantel (PZQ), an anthelmintic isoquinoline cestocide, can improve clinical outcomes in patients with rosacea.

Today, oral PZQ is considered a drug of choice in the treatment of schistosomiasis and, furthermore, is a highly effective category B medication that has been available for over 60 years and
has a good safety profile.

It is generally considered that therapy that eliminates microorganisms may have the potential to reduce or clear the symptoms of rosacea. Thus, a great deal of attention has been devoted to assessing the potential topical properties of this drug in the improvement of rosacea.

This study was conducted to test the effectiveness and safety of a novel 3% PZQ ointment and to carry out an in vitro/in vivo evaluation of this drug with the aim of extending the  armamentarium against rosacea

Praziquantel Antimicrobial Activity

A part of the study was to examine the antimicrobial activity of 3% PZQ.

The mean  SD reactions observed for the antimicrobial action of 3% PZQ ointment are presented below. The extent of the inhibitory zone depicting antimicrobial activity ranged from 6 mm to 17 mm for 3% PZQ ointment

MicroorganismMorphotypeInhibition Zone Value (mm)
Staphylococcus aureusGram-positive cocci11 (+-3)
Bacillus subtulisGram-positive cocci16 (+-3)
Escherichia coliGram-negative facultative anaerobic6
Pseudomonas aeruginosaGram-positive aerobic coccobacillus6
Candida albicansYeast6

Study Results

The researchers were able to show that the 3% PZQ Topical Ointment was able to significantly improve the clinical assessment of facial redness and also the overall quality of life index. Additionally the trial was able to demonstrate that the area of improvement extended extended from 6mm to 17mm around the treated area.

This is good news, these results may point to a new topical treatment for rosacea.

Article Abstract

Clinical and experimental assessment of the effects of a new topical treatment with praziquantel in the management of rosacea

Int J Dermatol. 2015 Apr;54(4):481-7

Mohamed Ridha Bribeche, MD, Valery P. Fedotov, MD, PhD, Vitaly V. Gladichev, Pharm. D, Daria M. Pukhalskaya, BS, Pharm, and Natalia L. Kolitcheva, MD, PhD

Departments of Dermatology and Venereology, Drug Chemistry and Technologies, and Microbiology, Zaporozhye State Medical University, Zaporozhye, Ukraine

Background: Rosacea is a common, chronic, and inflammatory skin disease. The burden imposed by this condition requires that new topical treatments be sought to enlarge the arsenal of drugs available in order to better manage this disease.

Objectives: This study was conducted to carry out an in vitro/in vivo evaluation of the antimicrobial activity of 3% praziquantel (PZQ) ointment and to determine its efficacy and safety in the treatment of rosacea.

Methods: Patients with rosacea (n = 65) participated in a 16-week, randomized, single- blind pilot study of the effects of twice-daily monotherapy with 3% PZQ ointment vs. placebo (vehicle ointment). Efficacy was assessed clinically using the Investigator’s Global Assessment Scale (IGAS) and the Clinical Erythema Assessment Scale (CEAS). Patients’ quality of life was also determined using the Dermatology Life Quality Index (DLQI). The antimicrobial potential of 3% PZQ ointment was assessed by agar diffusion assay.

Results: Scores on the IGAS and CEAS showed PZQ ointment to have a statistically significant therapeutic advantage over the placebo treatment (P < 0.001).

At week 16, the PZQ group demonstrated a statistically significant greater reduction in CEAS score than the placebo group (P < 0.001). Analysis of CEAS scores showed that 41.9% of patients in the PZQ group and 18.2% of those in the placebo group achieved a CEAS score equivalent to a rating of “none”.

Mean scores on the DLQI at baseline and at the end of the study were, respectively, 15.8 and 4.1 in the praziquantel group. The PZQ-treated group also experienced a statistically significant improvement in comparison with the placebo group at week 16 (P < 0.001).

The inhibitory zone indicating the extent of antimicrobial activity of 3% PZQ ointment ranged from 6 mm to 17 mm. No serious treatment-related adverse events occurred in either treatment group.

Conclusions: Use of 3% PZQ ointment twice daily for 12 weeks resulted in significantly better effects than a placebo treatment in improving rosacea and the patient’s quality of life.

 

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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3 Reader Comments

  1. David Pascoe says:

    comment via email.

    “Is this released already? How about in Canada? Thank you so much! I tried the “miracle” cream Olantra (canadas name for it) – used it for a week and on 5th day e
    reddness creeped back in such a weird way – started on my nose & just spread like wild fire – WAY more reddeness than ever before – and took a month to back to my “normal”
    state of reddness & flushing. Such a disapointment
    – Shame on Gladerma but good for some suffers I have read about. “

  2. Danni says:

    Wow, thanks for posting this. So glad they are finally believing something more is gong on. It’s about time. Hopefully they will start believing more sufferers also. It goes farther than the face, rosacea and a whole lot more!

  3. Rosie says:

    Very interesting. I can see how it’s microbial actions could help inflammatory redness associated with breakouts. But do you think it would help permanent redness from flushing?

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