Long-Term Clinical Outcomes Following Treatment of Actinic Keratosis with Imiquimod 5% Cream

Lee, Peter K.; Harwell, William B.; Loven, Keith; Phillips, Tania J.; Whiting, David; Andres, Kara L.; Lee, James H.

doi:10.1111/j.1524-4725.2005.31608

Cited by 26 publications

(7 citation statements)

References 16 publications

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“…Because 60% of procedures were performed for the Medicare population, an estimated $866 million was spent annually for destruction of AK for the entire population annually ( Table 2). 10 In addition, an estimated total of $54 million was spent annually on the topical treatment of AK in 1998 to 2000. Forty percent ($22 million) was spent on patients in the Medicare population.…”

Section: Resultsmentioning

confidence: 99%

“…Imiquimod was designed to enhance the normal immune response against abnormal cells to increase long-term clinical benefits, and a recurrence rate of only 25% was recently reported after 1.5 years after imiquimod treatment. 10 Other factors that may contribute to current practice patterns for the treatment of AK include efficacy of treatment, tolerability, and compliance. Topical chemotherapy with fluorouracil was proven to be efficacious for the treatment of AK; however, such treatment requires strict patient compliance and often causes erythema, burning, and irritation.…”

Section: Table 1 Comparison Of Actinic Keratoses (Ak) Visits In Medimentioning

confidence: 99%

See 1 more Smart Citation

Frequency and Cost of Actinic Keratosis Treatment

Warino¹,

Tusa²,

Camacho³

et al. 2006

Dermatol Surg

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Section: Resultsmentioning

confidence: 99%

Section: Table 1 Comparison Of Actinic Keratoses (Ak) Visits In Medimentioning

confidence: 99%

Frequency and Cost of Actinic Keratosis Treatment

Warino¹,

Tusa²,

Camacho³

et al. 2006

Dermatol Surg

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“…Absolute clearance rate is higher for the 5% cream, at 45%, compared to 35% for daily use of the 3.75% preparation [70], and the median reduction in AK is 83% [72]. Use of the 5% cream can give up to 57% clearance if used three times per week for 16 weeks [73–75]. …”

Section: Discussionmentioning

confidence: 99%

Actinic Keratosis: Rationale and Management

Dodds

Chia

Shumack

2014

Dermatol Ther (Heidelb)

105

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Actinic keratoses (AKs) are common skin lesions heralding an increased risk of developing squamous cell carcinoma (SCC) and other skin malignancies, arising principally due to excessive ultraviolet (UV) exposure. They are predominantly found in fair-skinned individuals, and increasingly, are a problem of the immunosuppressed. AKs may regress spontaneously, remain stable or transform to invasive SCC. The risk of SCC increases for those with more than 5 AKs, and the majority of SCCs arise from AKs. The main mechanisms of AK formation are inflammation, oxidative stress, immunosuppression, impaired apoptosis, mutagenesis, dysregulation of cell growth and proliferation, and tissue remodeling. Human papilloma virus has also been implicated in the formation of some AKs. Understanding these mechanisms guides the rationale behind the current available treatments for AKs. One of the main principles underpinning the management of AKs is that of field cancerization. Wide areas of skin are exposed to increasing amounts of UV light and other environmental insults as we age. This is especially true for the head, neck and forearms. These insults do not target only the skin where individual lesions develop, but also large areas where crops of AKs may appear. The skin between lesions is exposed to the same insults and is likely to contain as-yet undetectable preclinical lesions or areas of dysplastic cells. The whole affected area is known as the ‘field’. Management is therefore divided into lesion-directed and field-directed therapies. Current therapies include lesion-directed cryotherapy and/or excision, and topical field-directed creams: 5-fluorouracil, imiquimod, diclofenac, photodynamic therapy and ingenol mebutate. Combining lesion- and field-directed therapies has yielded good results and several novel therapies are under investigation. Treatment is variable and tailored to the individual making a gold standard management algorithm difficult to design. This literature review article aims to describe the rationale behind the best available therapies for AKs in light of current understanding of pathophysiology and epidemiology. A PubMed and MEDLINE search of literature was performed between January 1, 2000 and September 18, 2013. Where appropriate, articles published prior to this have been referenced. This is not a systematic review or meta-analysis, but aims to highlight the most up to date understanding of AK disease and its management.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-014-0049-y) contains supplementary material, which is available to authorized users.

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“…In an observational, 16-month follow-up study, 75Á3% of those receiving treatment three times a week over 8 weeks were clear at 16 months, in comparison with 57Á4% receiving the same treatment twice a week. 82 There is a small number of studies on imiquimod 3Á75% cream (strength of recommendation B, level of evidence 1+), which is licensed for treatment of AKs of the head and scalp with application once daily for two, 2-week periods separated by 2 weeks. Early studies had longer courses, applied once daily for two periods of 3 weeks separated by 3 weeks, over a 9-week course.…”

Section: Imiquimod 5% Cream (Strength Of Recommendation a Level Of Ementioning

confidence: 99%

British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis 2017

Berker¹,

et al. 2017

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Long-Term Clinical Outcomes Following Treatment of Actinic Keratosis with Imiquimod 5% Cream

Abstract: One and a half years following treatment, imiquimod continued to provide a long-term clinical benefit in a majority of patients who experienced complete clearance of their AK lesions.

Cited by 26 publications

References 16 publications

Frequency and Cost of Actinic Keratosis Treatment

Frequency and Cost of Actinic Keratosis Treatment

Actinic Keratosis: Rationale and Management

British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis 2017

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