Mirvaso is not for every red-faced rosacea sufferer

Written by on November 18, 2015 in Mirvaso Gel (Brimonidine 0.33%) with 1 Comment

A really interesting paragraph from Dr. Powell in the September 2015 BJD.

Understanding rosacea, Powell F.C., British Journal of Dermatology (2015) 173, pp635–640

Brimonidine tartrate gel 0.5%, a topical alpha 2 adrenergic agonist with vasoconstrictor properties, was shown to be effective in reducing moderate to severe erythema in patients with rosacea, a major benefit for these individuals.

However, while the reported adverse effects in the studies reviewed were ‘mild and transient’, increasing usage of this agent in practice has shown that a worsening of erythema during treatment with topical brimonidine gel can be seen in up to 20% of patients.

This reminds us that the genesis of facial erythema in patients with rosacea is likely to involve a variety of neurovascular mediators. Not all patients with facial erythema will benefit from this agent and until more specific indications for topical brimonidine use in patients with particular variants of facial erythema have been identified, clinicians should prescribe this agent with some degree of caution.

Well we already knew this of course, but here it is from one of the best known rosacea researchers, published in British Journal of Dermatology.

Mirvaso definitely has not enjoyed the same positive response since being approved, as it did during the large scale clinical trials. What is the reason for this fact? Was the clinical trial conducted in a sub-optimal way? Is rosacea just so much more complicated than a clinical trial can capture? Sadly I think we just don’t know.

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

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1 Reader Comment

  1. Lori S. says:

    I really appreciate your summaries of the research. Thank you!!

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