A Comparison of 15% Azelaic Acid Gel and 0.75% Metronidazole Gel in the Topical Treatment of Papulopustular Rosacea

Abstract

To compare the efficacy and safety of a novel formulation of 15% azelaic acid gel (Finacea; Berlex Laboratories, Inc, Montville, NJ) with 0.75% metronidazole gel (MetroGel; Galderma Laboratories LP, Fort Worth, Tex) as topical therapy for moderate, papulopustular facial rosacea.

Rosacea: an update on therapeutic options

“…Metronidazole has been compared with azelaic acid for therapeutic efficacy in rosacea and has been found to be as effective as the latter in clinical studies. 13,14 However, the overall effect of azelaic acid was found to be superior in these clinical trials.…”

Current Drug Therapies for Rosacea: A Chronic Vascular and Inflammatory Skin Disease

“…51 The exact mechanism of action is also unknown, but it may act through antikeratinizing and anti-inflammatory effects in rosacea. 53,[61][62][63][64][65][66] Azelaic acid downregulates cathelicidins by inhibiting serine protease KLK5 activity. 67,68 The most common treatment-related adverse events reported in 12-week and 15-week clinical trials were burning/ stinging/tingling (29%), pruritus (11%), scaling/dry skin/xerosis (8%), and erythema/irritation (4%).…”

Archives Features

“…Of those trials, 2 studies compared topical azelaic acid with topical metronidazole and were therefore excluded from the review. 16,17 Two other publications were duplicate studies (Hebert 18 and Thiboutot et al 19 ). The 5 remaining randomized controlled trials were included for systematic analysis ( Table 4).…”