Some just published research from the Ivermectin Phase III study group suggests that Ivermectin 1% cream once a day is better than Metronidazole 0.75% twice a day at treating the papules and pustules of rosacea.

The British Journal of Dermatology paper tells us that although both Ivermectin and Metronidazole did lead to a reduction in inflammatory lesions, Ivermectin did lead to a greater reduction overall. Also a benefit was observed in as little as 3 weeks. Adverse event rates were similar between the 2 treatments.

We know that Galderma continuing its development of this product known by its code CD5024 and it is believed that it may become available in 2014. We also know that there have been many patents filed that cover treating rosacea with Ivermectin.

A safe and viable alternative to Metrogel may be something interesting to those rosacea sufferers who have papules and pustules and do not respond to Metrogel.

Article Abstract

Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial.

Br J Dermatol. 2014 Sep 16.

Taieb A, Ortonne JP, Ruzicka T, Roszkiewicz J, Berth-Jones J, Peirone MH, Jacovella J; The ivermectin Phase III study group.

Demonstrate superiority of once-daily ivermectin 1% cream (IVM 1%) vs. twice-daily metronidazole 0.75% cream regarding percent reduction of inflammatory lesions in subjects with moderate to severe PPR.

BACKGROUND:  Few therapeutic alternatives currently exist in the treatment of papulopustular rosacea (PPR).

METHODS: In this Phase 3, investigator-blinded, randomized, parallel group study, subjects received IVM 1% once daily, or metronidazole 0.75% twice daily over 16 weeks.

Efficacy assessments were inflammatory lesion counts and Investigator’s Global Assessment (IGA).

Safety assessments included incidence of adverse events (AEs) and local tolerance parameters.

Subjects evaluated their disease following a 5-grade scale and completed questionnaires.

RESULTS:  A total of 962 subjects were randomized to receive IVM 1% (n=478) or metronidazole 0.75% (n=484).

At week 16, IVM 1% was significantly superior to metronidazole 0.75% in terms of reduction from baseline in inflammatory lesions (83.0% vs. 73.7%; p<.001), observed as early as week 3 (last observation carried forward – LOCF).

IGA results (subjects “clear” or “almost clear”) also favoured IVM 1%: 84.9% vs. 75.4%, respectively (p<.001).

Incidence of AEs was comparable between groups and local tolerability was better for IVM 1%.

More subjects receiving ivermectin rated their global improvement as “excellent” or “good.”

CONCLUSIONS:  Ivermectin 1% cream was significantly superior to metronidazole 0.75% cream and achieved high patient satisfaction.

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