Azelaic acid 15% gel: in the treatment of papulopustular rosacea.
Azelaic acid is a naturally occurring, straight-chain dicarboxylic acid which is effective in the treatment of rosacea, presumably on account of its anti-inflammatory properties. In randomized, double-blind, multicenter studies involving patients with moderate papulopustular facial rosacea, twice-daily topical application of azelaic acid 15% gel to the face was significantly more effective than twice-daily administration of either its vehicle (two studies) or metronidazole 0.75% gel (one study) in reducing inflammatory lesion counts and erythema severity. However, neither active treatment had a clinically discernable effect on telangiectasia. In all three studies, azelaic acid 15% gel recipients experienced continuous decreases in lesion counts and erythema throughout the 12- to 15-week treatment periods. However, the effects of metronidazole 0.75% gel plateauxed after 8 weeks. In other efficacy assessments in these studies, azelaic acid 15% gel was superior to its vehicle and metronidazole 0.75% gel in both the investigators' global assessment of rosacea and the investigators' end-of-study evaluation of overall improvement, and superior to its vehicle in the patients' end-of-study evaluation of overall improvement. The most frequent treatment-related cutaneous adverse events during administration of azelaic acid 15% gel include burning/stinging/tingling and pruritus (itching); however, these events are predominantly transient in nature and mild-to-moderate in intensity.
Frampton
James E
JE
Adis International Inc., Yardley, Pennsylvania 19067, USA. demail@adis.co.nz
Wagstaff
Antona J
AJ
D000279:Administration, Cutaneous; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003998:Dicarboxylic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D005782:Gels; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012393:Rosacea / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index
D003879:Dermatologic Agents; D003998:Dicarboxylic Acids; D005782:Gels; C010038:azelaic acid