- 5% fluorouracil cream is the most effective of 4 field-directed treatments for patients with multiple actinic keratosis (AK) lesions, according to data from a head-to-head randomized trial.
Why this matters
- No clear recommendations for treatment type are included in the current guidelines.
- At 3 and 12 months, fluorouracil was associated with higher rates of freedom from treatment failure (90.6% and 74.7%, respectively) compared with:
- imiquimod (75.8% and 53.9%, respectively; HR, 2.03; P=.001 for treatment failure),
- methyl aminolevulinate photodynamic therapy (MAL-PDT; 76.0% and 37.7%, respectively; HR, 2.73; P<.001 for treatment failure and>
- ingenol mebutate (67.3% and 28.9%, respectively; HR, 3.33; P<.001 for treatment failure>
- 624 patients with ≥5 AK lesions were randomly assigned to 5% fluorouracil cream (N=155), 5% imiquimod cream (N=156), MAL-PDT (N=156), or 0.015% ingenol mebutate gel (N=157) and analyzed for efficacy.
- Funding: Netherlands Organization for Health Research and Development.
- Overrepresentation of men in the trial population.
- Adherence in a trial may not reflect actual practice.