ALA-PDT on par with minocycline for moderate-to-severe rosacea

Patients with moderate-to-severe rosacea may benefit from treatment with 5-aminolevulinic acid photodynamic therapy (ALA-PDT), which has shown its efficacy and noninferiority to minocycline in a recent study.

A group of researchers compared the effect of ALA-PDT with minocycline on rosacea in this single-centre, randomized, evaluator-blind, controlled study. They assigned patients with moderate-to-severe rosacea to receive either three to five sessions of ALA-PDT or 8 weeks of minocycline 100 mg daily, followed by a 24-week follow-up.

Forty-four patients were included, of whom 41 completed their treatment (ALA-PDT: n=20; minocycline: n=21). ALA-PDT resulted in noninferior improvement of papulopustular lesions and Rosacea-specific Quality of Life (RQoL) relative to minocycline (median reduction of lesion count: 19 vs 22; median change of RQoL: 0.48 vs 0.53) at the end of treatment.

ALA-PDT achieved a much lower Clinician’s Erythema Assessment success than that of minocycline (35 percent vs 67 percent), but the density of demodex and release rate were comparable between the two treatment groups.

Of note, the most common adverse reactions associated with ALA-PDT were mild erythema, exudation, and mild pain.

“As minocycline does, ALA-PDT can improve rosacea mainly in papulopustular lesions and patients’ quality of life, indicating a new option for rosacea,” the researchers said.

This study was limited by its small sample size, which restricted the researchers from drawing further conclusions.