A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix)-PDT in actinic keratosis of the face and scalp.

Abstract

Photodynamic therapy (PDT) with topical methyl aminolevulinate (MAL) administered in two treatment sessions separated by 1 week is an effective treatment for actinic keratoses. This open prospective study compared the efficacy and safety of MAL-PDT given as a single treatment with two treatments of MAL-PDT 1 week apart. Two hundred and eleven patients with 413 thin to moderately thick actinic keratoses were randomized to either a single treatment with PDT using topical MAL (regimen I; n=105) or two treatments 1 week apart (regimen II; n=106). Each treatment involved surface debridement, application of Metvix cream (160 mg/g) for 3 h, followed by illumination with red light using a light-emitting diode system (peak wavelength 634+/-3 nm, light dose 37 J/cm2). Thirty-seven lesions (19%) with a non-complete response 3 months after a single treatment were re-treated. All patients were followed up 3 months after the last treatment. A total of 400 lesions, 198 initially treated once and 202 treated twice, were evaluable. Complete response rate for thin lesions after a single treatment was 93% (95% CI=87-97%), which was similar to 89% (82-96%) after repeated treatment. Response rates were lower after single treatment of thicker lesions (70% (60-78%) vs 84% (77-91%)), but improved after repeated treatment (88% (82-94%)). The conclusion of this study is that single treatment with topical MAL-PDT is effective for thin actinic keratosis lesions; however, repeated treatment is recommended for thicker or non-responding lesions.

• Authors: Mikael Tarstedt, Inger Rosdahl, Berit Berne, Katarina Svanberg, Ann-Marie Wennberg
• Journal: Acta dermato-venereologica (Acta Derm Venereol) Vol. 85 Issue 5 Pg. 424-8 ( 2005) ISSN: 0001-5555 [Print] Sweden
• PMID: 16159735 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Photosensitizing Agents
• methyl 5-aminolevulinate
• Aminolevulinic Acid

Topics

• Administration, Topical
• Aged
• Aminolevulinic Acid (administration & dosage, adverse effects, analogs & derivatives)
• Facial Dermatoses (drug therapy, etiology)
• Female
• Humans
• Keratosis (drug therapy, etiology)
• Male
• Photochemotherapy
• Photosensitizing Agents (administration & dosage, adverse effects)
• Scalp Dermatoses (drug therapy, etiology)
• Ultraviolet Rays (adverse effects)