title: Open label randomized study comparing 3 months vs. 6 months treatment of actinic keratoses with 3% diclofenac in 2.5% hyaluronic acid gel: a trial of the German Dermatologic Cooperative Oncology Group.
abstract: BACKGROUND
  Actinic keratoses (AK) are carcinomata in situ with the potential to develop into invasive carcinoma. Several studies have demonstrated that 3% diclofenac in 2.5% hyaluronic acid gel (HA) is effective and well tolerated in the treatment of AK. To date there are no large randomized multicentre trials with treatment durations longer than 90 days and histopathological control of treatment outcome.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether a prolonged treatment with diclofenac in HA of 6 vs. 3 months adds to the efficacy in treatment for AK and if this will influence tolerability and quality of life (QoL).
  
  
  METHODS
  This was a multicentre, randomized open-label study in which 418 patients with mild to moderate AKs were randomized into two treatment groups. Group A received diclofenac in HA for 3 months and group B for 6 months. Treatment efficacy was assessed by size measurement and a final biopsy of a defined marker AK. Quality of life was measured using the Dermatology Life Quality Index questionnaire.
  
  
  RESULTS
  Clinical complete clearance was observed in 40% in group A and in 45% in group B (P = 0.38). Histopathological clearance was confirmed in 30% in group A and in 40% in group B (P = 0.16). Treatment was well tolerated and QoL was significantly improved after treatment in both treatment groups.
  
  
  CONCLUSIONS
  Treatment with diclofenac in HA is effective and well tolerated during a treatment period of 3 months as well as 6 months. Prolongation of the treatment duration did not significantly affect treatment outcome.
authors.affiliation: Centre for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Berlin, Germany. annette.pflugfelder@med.uni-tuebingen.de
authors.forename: A
authors.initials: A
authors.lastname: Pflugfelder
authors.forename: A-K
authors.initials: AK
authors.lastname: Welter
authors.forename: U
authors.initials: U
authors.lastname: Leiter
authors.forename: B
authors.initials: B
authors.lastname: Weide
authors.forename: L
authors.initials: L
authors.lastname: Held
authors.forename: T K
authors.initials: TK
authors.lastname: Eigentler
authors.forename: T
authors.initials: T
authors.lastname: Dirschka
authors.forename: E
authors.initials: E
authors.lastname: Stockfleth
authors.forename: D
authors.initials: D
authors.lastname: Nashan
authors.forename: C
authors.initials: C
authors.lastname: Garbe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005858:Germany; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D006820:Hyaluronic Acid