A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea.

Abstract

BACKGROUND:

Although it is important for physicians to have sufficient clinical data on which to base treatment decisions, little comparative data exist regarding newer treatment modalities for rosacea.

OBJECTIVE:

The goal of the study was to compare the efficacy and safety of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. Parameters of patient satisfaction to treatment were also assessed.

METHODS:

Forty patients with the clinical manifestation of symmetric facial rosacea were investigated in this single-center, double-blind, randomized, contralateral split-face comparison clinical trial.

RESULTS:

After 15 weeks of treatment, both azelaic acid and metronidazole induced significant, albeit equal reductions in the number of inflammatory lesions (pustules and papules). A significantly higher physician rating of global improvement was achieved with azelaic acid. Changes in the rosacea signs and symptoms of dryness, burning, telangiectasia, and itching were equal between treatments. A reduction in erythema tended toward significance with azelaic acid at week 15. A trace amount of stinging on application was noted with azelaic acid; however, such discomfort did not appear to concern patients because their overall impression of azelaic acid was superior to that of metronidazole.

CONCLUSION:

Azelaic acid 20% cream provides an effective and safe alternative to metronidazole 0.75% cream with the added benefit of increased patient satisfaction.

• Authors: S Maddin
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 40 Issue 6 Pt 1 Pg. 961-5 (Jun 1999) ISSN: 0190-9622 [Print] United States
• PMID: 10365928 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Dermatologic Agents
• Dicarboxylic Acids
• Ointments
• Metronidazole
• azelaic acid

Topics

• Administration, Topical
• Adult
• Aged
• Dermatologic Agents (administration & dosage, adverse effects)
• Dicarboxylic Acids (administration & dosage, adverse effects)
• Double-Blind Method
• Humans
• Metronidazole (administration & dosage, adverse effects)
• Middle Aged
• Ointments
• Patient Satisfaction
• Rosacea (drug therapy, pathology)