Clinical Review: Brimonidine Gel for Treatment of Facial Erythema in Rosacea Patients

JULY 23, 2015
Bill Schu
Rosacea affects approximately 16 million people in the United States, and patients often present with a variety of symptoms and need an individualized treatment plan. Rosacea can affect the facial skin and, in about 1 in 5 cases, also the eyes, causing redness, irritation, and a burning sensation. There is no cure for rosacea.
Most treatments are intended to control the signs and symptoms that define the disease, and while those treatments are generally safe and effective, there are few medications that are FDA-approved to treat rosacea. Treatments for all four subtypes of the disease generally target inflammatory lesions, leaving a treatment gap in options to treat the persistent facial erythema that can occur in all subtypes.
A recent review article in Dermatology and Therapy looked at possible combination therapies with brimonidine tartrate 0.33% gel, approved in 2013 by the FDA for the topical treatment of persistent facial erythema associated with rosacea. Brimonidine gel is a highly selective α2-adrenergic receptor agonist (with an established safety profile over 20 years of treating open-angle glaucoma) that leads to significant reduction of persistent facial erythema in the majority of patients when applied once daily.
In large-scale clinical trials, brimonidine has been shown to be generally safe and effective, with adverse effects that are mild-to-moderate in degree and which often resolve spontaneously with continued use.
According to the study authors, “Significant improvement in erythema is experienced in the majority of patients with once-daily topical application with few experiencing mild to moderate cutaneous adverse effects that are often not persistent with continued use. This provides clinicians with a safe and effective treatment modality for this previously difficult to treat manifestation of rosacea, and it has been shown to be safely used in combination with other therapeutics targeting the inflammatory lesions of the disease.”

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