Lovastatin cream shows therapeutic potential in disseminated superficial actinic porokeratosis

In the treatment of patients with disseminated superficial actinic porokeratosis (DSAP), the use of topical lovastatin 2% cream may help improve outcomes, with the addition of cholesterol having a limited benefit, according to a study.

The study included 31 nonpregnant adults with a previous clinical or histological diagnosis of DSAP. They were randomly assigned to receive either lovastatin-cholesterol cream (n=17; mean age 59.2 years; 76.5 percent women) or lovastatin cream (n=14; mean age 53.7 years, 92.9 percent women) to symptomatic regions. Treatment was applied once or twice daily for 12 weeks.

The primary outcome was the DSAP General Assessment Severity Index (DSAP-GASI; scored from 0–4, with 0 indicating clear and 4 indicating severe) at week 12. This was evaluated based on investigator-standardized photographs provided by the participants due to the need for evaluation via telehealth during the COVID-19 pandemic. Secondary outcomes included patient-reported outcomes, application frequency, and adverse events (AEs).

A total of 24 participants, 12 in each treatment group, qualified for the analysis. Over 12 weeks of treatment, disease severity was halved. DSAP-GASI decreased from 3.08 points (95 percent confidence interval [CI], 2.57–3.60) at week 1 to 1.54 points (95 percent CI, 1.04–2.05) in the lovastatin-cholesterol group (p<0.001), and from 2.92 points (95 percent CI, 2.40–3.43) to 1.50 points (95 percent CI, 0.99–2.01) in the lovastatin group (p<0.001).

Application frequency at the end of 12 weeks did not significantly differ in the two treatment groups.

Adverse events documented included myalgia (n=2), creatine kinase level elevation (n=1), application discomfort (n=4), and rash (n=1). There were no cases of serious AEs reported, and all participants with an AE were able to complete the study.

The findings suggest that lovastatin cream may be a new primary treatment option for patients diagnosed with DSAP.