Severe rosacea: ivermectin/doxycycline combo bests monotherapy

  • J Am Acad Dermatol

  • International Clinical Digest
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Takeaway

  • Combined ivermectin 1% cream (IVM)/doxycycline 40 mg modified-release capsule (DMR) are associated with superior efficacy compared with IVM alone for patients with severe rosacea, according to a phase 3b/4 randomized controlled trial (RCT).

Why this matters

  • There have been few RCTs of combination therapies for rosacea.

Key results

  • Combined IVM/DMR was associated with a greater reduction in inflammatory lesions compared with IVM monotherapy at week 12 (−80.3% vs −73.6%; P=.032).
  • Combined IVM/DMR was associated with a greater reduction in Investigator’s Global Assessment (IGA) compared with IVM monotherapy at week 12 (P=.032).
  • Combined IVM/DMR was associated with a higher rate of 100% lesion clearance compared with IVM monotherapy at week 12 (17.8% vs 7.2%; P=.006).
  • Combined IVM/DMR was associated with faster onset of action (reduction in inflammatory lesions) at week 4 compared with IVM monotherapy (P=.007).
  • 4.4% of patients receiving combined IVM/DMR and 7.2% of patients receiving IVM alone experienced treatment-related adverse events.

Study design

  • 273 patients with severe rosacea (IGA=4), 135 who received combined IVM/DMR and 138 who received IVM alone, were included.
  • Funding: Galderma.

Limitations

  • Short trial duration.
  • No untreated control population.