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Efficacy of topical ivermectin and impact on quality of life in patients with papulopustular rosacea: A systematic review and meta-analysis.

Dermatol Ther. 2019 Dec 20;:e13203

Authors: Husein-ElAhmed H, Steinhoff M

Rosacea is a chronic inflammatory dermatosis involving certain facial areas. The multifactorial nature of this condition makes the management challenging. In addition, rosacea affects negatively to patients' quality of life (QoL). Despite the multiple articles supporting its use for papulopustular rosacea (PPR), there is a shortage of high-quality evidence researches comparing the efficacy of ivermectin cream (IVM) 1% with other available topical choices. Besides, the well-documented impaired of self-esteem and stigmatization of rosacea patients make essential to address which treatment can provide the greatest psychological, physical and social benefit. The objective of this work is to critically review and appraise the efficacy of topical IVM 1% in PPR and the impact in patients' QoL against other options. We carried out a search of literature from PubMed, MEDLINE, EMBASE, Cochrane and clinicaltrials.gov using the following descriptors: "rosacea" AND "ivermectin". Efficacy was assessed with the Investigator Global Assessment (IGA), and the impact on QoL was based on the DLQI score Six studies from 4 published articles were included. The meta-analysis estimated that more participants achieved "success" (IGA≤1) and "complete clearance" (IGA = 0) with IVM 1%. The overall effect estimate for IGA≤1 was: 1.56 [1.23-1.97], while for IGA = 0 it was: 1.72 [1.40-2.11]. The rate of participants achieving lower DLQI score, and thus, better QoL was higher with IVM 1%. The overall effect estimate was: 1.71 [1.34-2.18] at week 16# and 1.64 [1.38-1.94] at week 52#. This meta-analysis gives strong evidence that IVM 1% cream is the most effective topical treatment above other alternatives and it satisfies the impairment of social and working life with a sustained better QoL. Further studies confirming and extending this period of remission are warranted, as well as researches investigating the potential use of this agent in combination with other agents. This article is protected by copyright. All rights reserved.

PMID: 31863543 [PubMed - as supplied by publisher]

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