Successful therapy of ocular rosacea with topical ivermectin

Schaller, Martin; Pietschke, Katharina

doi:10.1111/bjd.16534

Cited by 13 publications

(16 citation statements)

References 9 publications

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“…The statistical analysis was by Two-Way ANOVA. Results shown as *p < 0.05,**p < 0.01,***p < 0.001, ****p < 0.0001, for all treated groups compared to vehicle (naïve) control group and # p < 0.05, ## p < 0.01, ### p < 0.001, #### p < 0.0001 represent comparison between levels on Day 7 and 21 within a group safety based on the dermatotoxicity test results and also supported by clinical evidence of effectiveness in treating inflammatory conditions [16].…”

Section: Discussionmentioning

confidence: 76%

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Mechanisms of ivermectin-induced wound healing

et al. 2020

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Background Wounds cause structural and functional discontinuity of an organ. Wound healing, therefore, seeks to re-establish the normal morphology and functionality through intertwined stages of hemostasis, inflammation, proliferation, and tissue remodelling. Ivermectin, a macrolide, has been used as an endectoparasiticide in human and veterinary medicine practice for decades. Here, we show that ivermectin exhibits wounding healing activity by mechanisms independent of its well-known antiparasitic activity. This study aimed to evaluate the wound healing property of ivermectin cream using histochemistry and enzyme-linked immunosorbent assay techniques. Results Non-irritant dose of ivermectin cream (0.03–1%) decreased wound macroscopic indices such as exudation, edge edema, hyperemia, and granulation tissue deposition by day 9 compared to day 13 for the vehicle-treated group. This corresponded with a statistically significant wound contraction rate, hydroxyproline deposition, and a decreased time to heal rate. The levels of growth factors TGF-β1 and VEGF were significantly elevated on day 7 but decreased on day 21. This corresponded with changes in cytokines (IL-1α, IL-4, IL-10, and TNF-α) and eicosanoids (LTB4, PGE2, and PGD2) levels on days 7 and 21.. Interestingly, low doses of ivermectin cream (0.03–0.1%) induced wound healing with minimal scarring compared to higher doses of the cream and the positive control, Silver Sulfadiazine. Conclusion Ivermectin promotes wound healing partly through modulation of the inflammatory process and the levels of Transforming Growth Factor-Beta 1 and Vascular Endothelial Growth Factor. Low doses of ivermectin cream have the potential to be used in treating wounds with minimal scar tissue formation.

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Section: Discussionmentioning

confidence: 76%

“…Ivermectin has been used in the treatment of parasite-infected wounds in medicine. The main objective of this study was to determine whether ivermectin, a wellknown antiparasitic agent, exhibits wound healing property and elucidate the mechanisms involved [16].…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of ivermectin-induced wound healing

et al. 2020

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“…Artificial tear substitutes help ocular dryness and accompanying burning and stinging. Successful therapy with topical ivermectin was recently reported 94 . In more severe cases, cyclosporine eye drops and systemic tetracycline can be prescribed 73 .…”

Section: Ocular Rosaceamentioning

confidence: 99%

Recent advances in understanding and managing rosacea

2018

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Rosacea is a common chronic inflammatory skin disease of the central facial skin and is of unknown origin. Currently, two classifications of rosacea exist that are based on either “preformed” clinical subtypes (erythematotelangiectatic, papulopustular, phymatous, and ocular) or patient-tailored analysis of the presented rosacea phenotype. Rosacea etiology and pathophysiology are poorly understood. However, recent findings indicate that genetic and environmental components can trigger rosacea initiation and aggravation by dysregulation of the innate and adaptive immune system. Trigger factors also lead to the release of various mediators such as keratinocytes (for example, cathelicidin, vascular endothelial growth factor, and endothelin-1), endothelial cells (nitric oxide), mast cells (cathelicidin and matrix metalloproteinases), macrophages (interferon-gamma, tumor necrosis factor, matrix metalloproteinases, and interleukin-26), and T helper type 1 (T H1) and T H17 cells. Additionally, trigger factors can directly communicate to the cutaneous nervous system and, by neurovascular and neuro-immune active neuropeptides, lead to the manifestation of rosacea lesions. Here, we aim to summarize the recent advances that preceded the new rosacea classification and address a symptom-based approach in the management of patients with rosacea.

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“…This agent has a similar structure of macrolide antibiotics, and it belongs to a class of broad spectrum anti-parasitic drugs that are isolated from the fermentation of Streptomyces avermitilis (Crump, 2017). Although the ocular rosacea has successfully managed with this topical drug (Schaller & Pietschke, 2018). Although the ocular rosacea has successfully managed with this topical drug (Schaller & Pietschke, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Real-life experience on effectiveness and tolerability of IVM 1% in a retrospective study based on 50 patients has showed effective response not only in moderate to severe PPR but also in almost clear and mild cases (Trave, Merlo, Cozzani, & Parodi, 2019). Although the ocular rosacea has successfully managed with this topical drug (Schaller & Pietschke, 2018). Furthermore, the IVM-related reduction of the erythema has been satisfactorily observed not only with naked eye, but with digital photographic devices (Dall'Oglio, Lacarrubba, Luca, Boscaglia, & Micali, 2019).…”

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confidence: 98%

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

Husein‐ElAhmed

Steinhoff

2020

Dermatologic Therapy

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Rosacea is a chronic dermatosis which affects negatively patients' quality of life (QoL).There is shortage of high-quality evidence 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 provides the greatest psychological and social benefit. Our objective is to critically review and appraise the efficacy of IVM 1% in PPR and the impact in patients' QoL against other options. We carried out a literature search 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 four published articles were included. The meta-analysis estimated that more participants achieved "success" (IGA ≤ 1) and "complete clearance" (IGA = 0) with IVM1%. The overall effect estimate for IGA ≤ 1 was: 1.56 [1.23-1.97], whereas for IGA = 0, it was: 1.72 [1.40-2.11]. The rate of participants achieving lower DLQI score, and thus, better QoL was 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 confirms IVM 1% cream as the most effective topical treatment and it satisfies the impairment of social life with sustained better QoL. Further studies extending this period of remission are warranted, as well as researches about the potential application of this agent combined with other agents. KEY POINTSQuestion: What is the current efficacy of ivermectin versus other choices in papulopustular rosacea and its impact on patients' quality of life?Findings: In this meta-analysis, ivermectin showed higher efficacy than metronidazol, azelaic acid, and placebo measured by Investigator Global Assessment. Parallely, the DLQI score highlighted that this agent was more beneficious in both short and long-term.Meaning: This meta-analysis gives strong evidence that ivermectin is the most effective topical treatment. Besides, this agent provides the greatest psychological benefit

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Successful therapy of ocular rosacea with topical ivermectin

Cited by 13 publications

References 9 publications

Mechanisms of ivermectin-induced wound healing

Mechanisms of ivermectin-induced wound healing

Recent advances in understanding and managing rosacea

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

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