The off label use for Mirvaso gel is becoming better documented with the publication of a recent paper suggesting that Mirvaso was well tolerated by and offered good benefits to sufferers of Systemic Lupus, Dermatomyositis and Pityriasis Rubra Pilaris.
These conditions share a symptom – erythema, that is the appearance of a red face. Only 3 patients are described, all whom tolerated Mirvaso ok and had an “excellent clinical response” – that is their red face went away.
- Systemic Lupus: a typical skin manifestation of SLE is a butterfly shaped rash on the face and photosensitivity.
- Dermatomyositis: is characterised by red scaly eruptions, on eyelids, back shoulders.
- Pityriasis Rubra Pilaris: (PRP) is the name given to a group of rare skin disorders that present with reddish-orange coloured scaling patches with well defined borders.
Mirvaso Off Label
Now that Galderma has a FDA approved treatment for the red face of rosacea we might expect to see more discussion of using Mirvaso off-label for dermalogocial conditions.
I wonder if Mirvaso might even have a better tolerance and lower adverse reaction profile in other conditions than the sometimes hyper reactive skin experienced by many rosacea sufferers. Worth thinking about.
Del Barrio-Díaz P, Moll-Manzur C, Vera-Kellet C.
J Eur Acad Dermatol Venereol. 2016 Mar 16
BACKGROUND: Clinicians have recognized the impact of cutaneous signs and symptoms in patient’s quality of life over the years. Often, systemic response to a certain therapy is faster than the cutaneous response, leading to patient frustration and treatment discontinuation. Brimonidine gel is an alpha-2 adrenergic agonist recently approved by the FDA for the treatment of persistent facial erythema of rosacea.
OBJECTIVES AND METHODS: We describe 3 patients with recalcitrant facial erythema secondary to dermatomyositis, pityriasis rubra pilaris and systemic lupus. Their main complaint was facial erythema that was persistent even though they were under systemic treatment. Empirically, we decided to try topical Brimonidine gel for the treatment of their facial erythema as a rescue measure.
RESULTS: 30 minutes after we applied 0.5% Brimonidine gel in the office, we achieved an excellent clinical response, without adverse effects in all of these patients.
CONCLUSION: Topical Brimonidine gel may be a complementary therapy for the management of recalcitrant facial erythema in patients with systemic lupus, dermatomyositis and pityriasis rubra pilaris.