5-Aminolaevulinic acid patch photodynamic therapy for the treatment of actinic keratoses: preliminary results from an Italian study in the real-life setting

Dattola, Annunziata; García-Rodrigo, Carlota Gutiérrez; Tambone, Sara; Garofalo, Virginia; Lappi, Astrid; Luca, Emilia; Peris, Ketty; Bianchi, Luca; Campione, Elena; Fargnoli, Maria Concetta

doi:10.23736/s0392-0488.20.06598-0

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…A multicenter real-world clinical study with 5-ALA patch PDT to treat AK of the face, scalp, and/or upper extremities showed complete response in 87% of grade I AK and in 47% of grade II-III lesions. The lower response rate for grade II-III lesions was in line with responses observed with other photosensitizers used in c-PDT or dl-PDT [83].…”

Section: Photodynamic Therapysupporting

confidence: 83%

A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions

et al. 2022

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Actinic keratosis (AK) is a chronic skin disease in which clinical and subclinical cutaneous lesions coexist on sun-exposed areas such as the head and neck region and the extremities. The high prevalence of AK means the disease burden is substantial, especially in middle-aged and elderly populations. Evidence indicates that AK may progress into invasive cutaneous squamous cell carcinoma, so the European guidelines recommend treatment of any AK regardless of clinical severity. Given the aging population and therefore the increasing incidence of AK and cutaneous field carcinogenesis, further updates on the long-term efficacy of current therapies and new investigational agents are critical to guide treatment choice. Patients often have difficulty adequately applying topical treatments and coping with adverse local skin reactions, leading to less than optimum treatment adherence. The development of associated local skin symptoms and cosmetic outcomes for the area of interest are also relevant to the choice of an appropriate therapeutic strategy. Treatment is always individually tailored according to the characteristics of both patients and lesions. This review focuses on the therapeutic approaches to AK and illustrates the currently available home-based and physician-managed treatments.

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Section: Photodynamic Therapysupporting

confidence: 83%

A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions

et al. 2022

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“…7 Photodynamic therapy (PDT) with either 5-aminolevulinic acid hydrochloride (ALA) or its methyl ester (methyl[5-amino-4oxopentanoat]-hydrochloride, MAL) are approved and clinically established methods for the management of AK. 8,9 The principle of PDT involves the penetration of exogenously applied ALA or MAL into the AK and metabolism to the photosensitising molecule protoporphyrin IX (PPIX) on a cellular level. When subsequently excited with visible blue or red light, PPIX will lead to cell damage and cell death by the generation of reactive oxygen species.…”

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confidence: 99%

5‐ALA loaded self‐adhesive patch‐PDT is effective and safe in the treatment of actinic keratoses on hands and arms

Bai-Habelski

Ortland

et al. 2022

Experimental Dermatology

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Photodynamic therapy (PDT) with 5‐aminolevulinic acid hydrochloride (ALA) is an established method for the management of AK. PD P 506 A (brand name Alacare®) is an approved medicinal product for the treatment of AK located on scalp and face. It is a self‐adhesive, light‐proof patch loaded with 5‐ALA HCl and was developed for easy handling. AK located on arms, hands or trunk do not respond as well to ALA‐PDT as AK lesions on the head do. It has been reported that occlusion during ALA incubation can improve clinical outcome after ALA‐PDT for AK on hands and arms. We present the results of a first explorative pilot study involving 20 participants with a total of 145 treated (122 evaluable) AK lesions. The trial investigated the conduct of two ALA‐PDTs within 1–2 weeks and involved all severity grades of AK. The model‐based percentage of complete clearance on lesion‐basis was estimated being 78.0% (95%‐CI: [64.6%, 87.3%]), and the by‐participant calculation (patient‐based clearance) led to similar results (78.7% with a 95%‐CI of [67.0%, 90.3%]). The treatment was well tolerated. Local reactions during ALA patch incubation were rare whereas nearly all patients showed the expected reactions during or after the illumination, primarily erythema and pain. The study results indicate that two PD P 506 A‐PDT sessions 1–2 weeks apart are an efficacious treatment for AK on hands and arms. Especially mild but also moderate lesions responded very well to PDT treatment involving ALA incubation under occlusion.

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Principles of Photodynamic Therapy

Ibbotson,

McKenna

2024

Rook's Textbook of Dermatology

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Topical photodynamic therapy (PDT) is widely used as an effective and well‐tolerated treatment for field change actinic keratosis, Bowen disease and superficial basal cell carcinoma. There is a strong evidence base to support its use and guidelines, which summarise the evidence and clinical utility of this therapy. There are also standards available for guidance with respect to establishing PDT services in dermatology and emphasis is placed on the availability of PDT for practitioners affiliated with a skin cancer multi‐disciplinary team. Developments in photosensitisers and light delivery, such as through the increasing application of daylight PDT, have greatly improved the tolerance, acceptability and uptake of PDT, such that this should be widely available through dermatology services. Further refinements in photosensitiser and light delivery will be expected to continue to improve PDT outcomes and the uptake of this invaluable therapeutic approach.

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5-Aminolaevulinic acid patch photodynamic therapy for the treatment of actinic keratoses: preliminary results from an Italian study in the real-life setting

Cited by 4 publications

References 25 publications

A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions

A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions

5‐ALA loaded self‐adhesive patch‐PDT is effective and safe in the treatment of actinic keratoses on hands and arms

Principles of Photodynamic Therapy

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