Dr. Joseph Fowler Jr. and co-workers have just published a very interesting paper in the British Journal of Dermatology:
Once-daily topical brimonidine tartrate gel 0.5% is a novel treatment of moderate to severe facial erythema of rosacea: results of two multicenter randomized and vehicle-controlled studies.
Br J Dermatol. 2011 Nov 2. PMID: 22050040
The authors present the background of the clinical problem underlining in their article that rosacea is a very common disorder in the dermatological setting. Moreover, due to its tendency to recur involving the central facial area and coexisting with frequent flushing episodes, rosacea can become a skin condition with important emotional impact. Inflammatory lesions of rosacea, such as papules and pustules, can be managed with systemic tetracyclines, azelaic acid or metronidazole. Unfortunately, there is currently no approved drug for the treatment of facial erythema in the context of rosacea, although it is a feature that is present in nearly all the patients. Erythema in patients suffering from rosacea is thought to be caused by a malfunction in the cutaneous vasomotor system, resulting in pathological vasodilatation. Brimonidine tartrate (BT) is a highly selective alfa2-adrenergic receptor agonist, and therefore a potent vasoconstrictive agent.
The authors communicate two Phase II studies focusing on the efficacy and safety of BT in the treatment of moderate to severe erythema of rosacea, as well as to determine its optimal dose regimen.
The authors conclude that:
- BT gel 0.5 % applied once a day significantly reduces erythema compared to the vehicle gel.
- Treatment is well tolerated. Patients must be instructed to avoid eye contact in order to prevent from intra-ocular pressure decrease.
- No tachyphylaxis or worsening of inflammatory lesions is observed.
In conclusion, this is an original article reporting promising results for a frequent and challenging condition.