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Published online: 8 August 2015
© Springer International Publishing Switzerland 2015
Abstract Ivermectin 1 % cream (Soolantra^; RosiverTM; Izefla^) is a novel topical agent indicated for the once-daily treatment of inflammatory lesions of rosacea. Ivermectin is a derivative of the avermectin family of macrocyclic lactone parasiticides. It displays anti-inflammatory properties as well as broad-spectrum anti-parasitic activity, both of which may contribute to its efficacy in treating rosacea. In phase III trials of 12 or 16 weeks' duration in adults with moderate to severe papulopustular rosacea, once-daily ivermectin 1 % cream improved the symptoms of rosacea (as per Investigator Global Assessment and inflammatory lesion count) and health-related quality of life versus vehicle, and was more effective than twice-daily metronidazole 0.75 % cream in terms of these measures. Ivermectin 1 % cream continues to provide benefit for up to 52 weeks of treatment, according to extension studies, and is well tolerated, with the most common treatment-related adverse events (skin burning sensation, pruritus, dry skin and skin irritation) each occurring with low incidence (\2 %). Thus, ivermectin 1 % cream is an effective and well tolerated option for the topical treatment of inflammatory lesions of rosacea, with the convenience of oncedaily application.
1 Introduction
Rosacea is a common chronic inflammatory skin disease that occurs mainly in adults [1, 2]. The affected skin is usually located centrally on the face and can sting and feel like it is burning; these sensations may also be accompanied by inflammatory lesions (e.g. pustules/papules), erythema, scaling and/or phymatous growth, which can be disfiguring and distressing [1-3]. Of the various forms of rosacea (classified mainly on the basis of symptoms and lesion morphology [4]), papulopustular rosacea, which is characterized by persistent erythema and transient papules/pustules, is one of the most inflammatory [2]; however, in practice, the range of symptoms experienced by patients with rosacea often overlap more than one subtype [4].
At present, the cause of rosacea is not fully understood, but is thought to be driven predominantly by heightened immune detection/response and neurovascular dysregulation [5]. Pharmacological agents that target inflammatory pathways associated with rosacea have historically been the focus of therapy [1, 5], with topical metronidazole or azelaic acid and oral antibacterials (mainly of the tetracycline class) being widely used for...