Section : Notes de congrès/conférences

Rosacea Treatment with Topical Ivermectin

Comparative Efficacy and Safety of Ivermectin Cream 1% and Metronidazole 0.75% in the treatment of papulopustular Rosacea

Taieb A. et al

AAD 2015 Annual Meeting, San Francisco CA – United States


  • 962 subjects enrolled
  • evaluation of recurrence 36 weeks after
  • study done over 16 weeks
  • Evaluation of Rosacea severity in both treated groups (metronidazole 0.75% vs ivermectin 1%)
    • Investigator Global Assessment (IGA): moderate to severe papulopustular Rosacea
    • 15 to 70 facial papulopustular lesions (papules and pustules)
    • 32 inflammatory lesions on average
    • moderate rosacea (IGA of 3)
  • Evaluation of results:
    • blinded assessments at weeks 3, 6, 9, 12, 16:
    • IGA
    • inflammatory lesion counts
    • adverse effects
    • patient self-evaluation and questionnaire at week 16


  • Efficacy
    • Statistically significant reduction of:
      • inflammatory lesions (83% (Ivermectin) vs 73.3% (metronidazole) seen from week 12
      • IGA of clear or almost clear (84.9% vs 75.4% of cases)
      • patients reported excellent or good compared (85.5% vs 74.8%)
      • 34.9% of patients on ivermectin were completely clear (vs 21.7% with metronidazole)
  • Safety:
    • Adverse Events 32.4% for vs 33.1% (metronidazole)
    • Related Adverse Events (2.3% vs 3.7%) (for related dermatological Adverse Events 1.9% vs 2.5%)
  • Tolerability:
    • stinging/burning (15.5% vs 11.1%)
    • dryness (12.8% vs 10%
    • itching (11.4% vs 8.8%)


  • Ivermectin is available as a topical cream called Soolantra in the United States
  • For the results:
    • Although mentioned in the methods, the data concerning the recurrence was not published
    • It might have been interesting to compare the efficacy with two other topicals used in the treatment of Rosacea: Brimonidine and Azelaic Acid
    • There appears to be around 10% superior improvement rate with ivermectin compared with metronidazole.
    • Also, the clearance rate is around a third of cases in ivemectin group  vs a fifth in the metronidazole group
  • For the safety:
    • there is no mention of what the Adverse Events or Related Adverse events are
    • there is no mention of the results being statistically different in Ivermectin vs Metronidazole
    • Although written as a take home message, no conclusions can be made concerning safety (compared with metronidazole): although a small difference seems to appear, it has no statistically significant power
  • For Acne, studies have compared oral treatments with oral treatments. It is interesting to note that this has NOT been done for Rosacea.


Dr Christophe HSU – dermatologist. Geneva, Switzerland