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Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea.
J Eur Acad Dermatol Venereol. 2017 Nov; 31(11):1907-1911.JE

Abstract

BACKGROUND

Recently, therapy of rosacea with inflammatory lesions (papulopustular) has improved substantially with the approval of topical ivermectin 1% cream. It is assumed to have a dual mode of action with anti-inflammatory capacities and anti-parasitic effects against Demodex, which however has not yet been demonstrated in vivo.

AIM

To find scientific rationale for the dual anti-inflammatory and anti-parasitic mode of action of topical ivermectin 1% cream in patients with rosacea.

METHODS

A monocentric pilot study was performed including 20 caucasion patients with moderate to severe rosacea, as assessed by investigator global assessment (IGA score ≥3) and a Demodex density ≥15/cm[2] . Patients were treated with topical ivermectin 1% cream once daily (Soolantra[®]) for ≥12 weeks. The density of Demodex mites was assessed with skin surface biopsies. Expression of inflammatory and immune markers was evaluated with RT-PCR and by immunofluorescence staining.

RESULTS

The mean density of mites was significantly decreased at week 6 and week 12 (P < 0.001). The gene expression levels of IL-8, LL-37, HBD3, TLR4 and TNF-α were downregulated at both time points. Reductions in gene expression were significant for LL-37, HBD3 and TNF-α at both follow-up time points and at week 12 for TLR4 (all P < 0.05). Reduced LL-37 expression (P < 0.05) and IL-8 expression were confirmed on the protein level by immunofluorescence staining. All patients improved clinically, and 16 of 20 patients reached therapeutic success defined as IGA score ≤1.

CONCLUSION

Topical ivermectin 1% cream acts by a dual, anti-inflammatory and anti-parasitic mode of action against rosacea by killing Demodex spp. in vivo, in addition to significantly improving clinical signs and symptoms in the skin.

Authors+Show Affiliations

Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28653460

Citation

Schaller, M, et al. "Dual Anti-inflammatory and Anti-parasitic Action of Topical Ivermectin 1% in Papulopustular Rosacea." Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 31, no. 11, 2017, pp. 1907-1911.
Schaller M, Gonser L, Belge K, et al. Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea. J Eur Acad Dermatol Venereol. 2017;31(11):1907-1911.
Schaller, M., Gonser, L., Belge, K., Braunsdorf, C., Nordin, R., Scheu, A., & Borelli, C. (2017). Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea. Journal of the European Academy of Dermatology and Venereology : JEADV, 31(11), 1907-1911. https://doi.org/10.1111/jdv.14437
Schaller M, et al. Dual Anti-inflammatory and Anti-parasitic Action of Topical Ivermectin 1% in Papulopustular Rosacea. J Eur Acad Dermatol Venereol. 2017;31(11):1907-1911. PubMed PMID: 28653460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea. AU - Schaller,M, AU - Gonser,L, AU - Belge,K, AU - Braunsdorf,C, AU - Nordin,R, AU - Scheu,A, AU - Borelli,C, Y1 - 2017/08/29/ PY - 2017/04/12/received PY - 2017/06/12/accepted PY - 2017/6/28/pubmed PY - 2018/7/11/medline PY - 2017/6/28/entrez SP - 1907 EP - 1911 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 31 IS - 11 N2 - BACKGROUND: Recently, therapy of rosacea with inflammatory lesions (papulopustular) has improved substantially with the approval of topical ivermectin 1% cream. It is assumed to have a dual mode of action with anti-inflammatory capacities and anti-parasitic effects against Demodex, which however has not yet been demonstrated in vivo. AIM: To find scientific rationale for the dual anti-inflammatory and anti-parasitic mode of action of topical ivermectin 1% cream in patients with rosacea. METHODS: A monocentric pilot study was performed including 20 caucasion patients with moderate to severe rosacea, as assessed by investigator global assessment (IGA score ≥3) and a Demodex density ≥15/cm[2] . Patients were treated with topical ivermectin 1% cream once daily (Soolantra[®]) for ≥12 weeks. The density of Demodex mites was assessed with skin surface biopsies. Expression of inflammatory and immune markers was evaluated with RT-PCR and by immunofluorescence staining. RESULTS: The mean density of mites was significantly decreased at week 6 and week 12 (P < 0.001). The gene expression levels of IL-8, LL-37, HBD3, TLR4 and TNF-α were downregulated at both time points. Reductions in gene expression were significant for LL-37, HBD3 and TNF-α at both follow-up time points and at week 12 for TLR4 (all P < 0.05). Reduced LL-37 expression (P < 0.05) and IL-8 expression were confirmed on the protein level by immunofluorescence staining. All patients improved clinically, and 16 of 20 patients reached therapeutic success defined as IGA score ≤1. CONCLUSION: Topical ivermectin 1% cream acts by a dual, anti-inflammatory and anti-parasitic mode of action against rosacea by killing Demodex spp. in vivo, in addition to significantly improving clinical signs and symptoms in the skin. SN - 1468-3083 UR - https://brain.unboundmedicine.com/medline/citation/28653460/Dual_anti_inflammatory_and_anti_parasitic_action_of_topical_ivermectin_1_in_papulopustular_rosacea_ DB - PRIME DP - Unbound Medicine ER -