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Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review.

Br J Dermatol. 2011 Jun 21;

Authors: van Zuuren EJ, Kramer SF, Carter BR, Graber MA, Fedorowicz Z

Background:  Rosacea is a common chronic skin disease affecting the face. There are numerous treatment options, but it is unclear which are the most effective. Objective:  To assess the evidence for the efficacy and safety of treatments for rosacea. Methods:  Searches included the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and Ongoing Trials Registers (updated February 2011). Randomized controlled trials in people with moderate to severe rosacea were included. Results:  Fifty-eight trials, including 27 from the original review, comprising 6,633 participants were included in this updated review. Interventions included topical metronidazole, oral antibiotics, topical azelaic cream or gel, topical benzoyl peroxide and/or combined with topical antibiotics, sulphacetamide/sulphur, and others. There was some evidence that topical metronidazole and azelaic acid were more effective than placebo. Two trials indicated that doxycycline 40 mg was more effective than placebo. There was no statistically significant difference in effectiveness between doxycycline 40 mg and 100 mg and with evidence of less adverse effects. One study reported that cyclosporine ophthalmic emulsion was significantly more effective than artificial tears for treating ocular rosacea. Conclusions:  Although the majority of included studies were assessed as being at high or unclear risk of bias, there was some evidence to support the effectiveness of topical metronidazole, azelaic acid, and doxycycline (40 mg) in the treatment of moderate to severe rosacea, and cyclosporine 0.05% ophthalmic emulsion for ocular rosacea. Further well-designed, adequately-powered randomised controlled trials are required.

PMID: 21692773 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=21692773&dopt=Abstract = URL to article

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