title: Efficacy of imiquimod 3.75% from Lmax according to the number of actinic keratosis lesions.
abstract: BACKGROUND
  Imiquimod 3.75% reduces 92.2% of all actinic keratosis (AK) lesions, assumed to include both subclinical and clinical lesions, across a large sun-exposed field such as the full face or balding scalp.
  
  
  OBJECTIVE
  To evaluate the efficacy of imiquimod 3.75% using the reduction in lesions from Lmax (the maximum lesion count during treatment) in subgroups of patients with low and high AK lesion counts.
  
  
  METHODS
  Patients from two 14-week, placebo-controlled, double-blind studies were subgrouped according to whether they had ≤ 10 or >10 AK lesions at baseline. Treatment was applied to the full face or balding scalp during two 2-week treatment cycles separated by a 2-week treatment-free interval.
  
  
  RESULTS
  Overall, 167 patients had ≤ 10 lesions and 152 patients had >10 AK lesions at baseline. With imiquimod 3.75%, the median percentage reduction in AK lesions from Lmax to end of study was similar in patients with ≤ 10 and >10 baseline lesions (91.5% and 93.0% respectively). The median absolute reduction in AK lesions from Lmax to end of study was 24.0 for patients with >10 baseline lesions and 10.0 for those with ≤ 10 baseline lesions. The median percentage and absolute reductions in lesions from Lmax were significantly greater with imiquimod 3.75% vs. placebo (P < 0.0001).
  
  
  CONCLUSIONS
  Imiquimod 3.75% is effective regardless of disease severity as shown in this study by the reduction of over 90% of lesions from Lmax in patients with low or high AK lesion counts.
authors.affiliation: Department of Dermatology, Catholic University of Rome, Rome, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Peris
authors.affiliation: Department of Dermatology, Charité - University Medical Centre Berlin, Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Stockfleth
authors.affiliation: Department of Dermatology, Monklands Hospital, Airdrie, Lanarkshire, UK.
authors.forename: G
authors.initials: G
authors.lastname: Gupta
authors.affiliation: Service de Dermatologie Allergologie, Hôpital Cochin, Paris, France.|Université Paris 5 Descartes, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Aractingi
authors.affiliation: Meda Pharma GmbH & Co. KG, Bad Homburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dakovic
authors.affiliation: Dermatological Practice Centre, Wuppertal, Germany.|Faculty of Health, University Witten-Herdecke, Witten, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Dirschka
authors.affiliation: Department of Dermatology, Institut Universitari Quiron Dexeus, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Alomar
mesh_terms: D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005145:Face; D005148:Facial Dermatoses / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077271:Imiquimod; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012535:Scalp; D012536:Scalp Dermatoses / Q000188:drug therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod