Combined versus conventional photodynamic therapy with 5‐aminolaevulinic acid nanoemulsion (BF‐200 ALA) for actinic keratosis: A randomized, single‐blind, prospective study

Sáenz‐Guirado, Soledad; Cuenca‐Barrales, Carlos; Vega-Castillo, Jorge Juan; Linares‐González, Laura; Ródenas‐Herranz, Teresa; Molina‐Leyva, Alejandro; Ruiz‐Villaverde, Ricardo

doi:10.1111/phpp.12753

Cited by 3 publications

(3 citation statements)

References 36 publications

(72 reference statements)

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“…4 Continuous activation of low levels of PpIX using shorter incubation times, lower irradiance, and daylight or combined PDT may decrease pain without loss of efficacy in AK. 15,16,19,20 However, few modifications to conventional ALA-PDT protocols have been rigorously evaluated in clinical trials, and even fewer are backed by FDA approval. Larger, randomized, controlled studies, particularly those evaluating daylight and combination PDT, are needed to standardize these protocols, strengthen the evidence base, and support reimbursement in AK and other indications.…”

Section: Discussionmentioning

confidence: 99%

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The Interventions to Minimize Pain During Photodynamic Therapy With 5-Aminolevulinic Acid for the Treatment of Cutaneous Diseases

Bhatia

2023

JDD

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Photosensitization with 5-aminolevulinic acid (ALA) combined with photodynamic therapy (PDT) is approved in the United States for the treatment of actinic keratosis (AK) and is used off-label for other indications including acne treatment and photo rejuvenation. However, pain, particularly during the initial illumination period, limits the utility of this highly efficacious therapy. Although modifications to conventional ALA-PDT protocols that improve tolerability without diminishing efficacy have been identified, few have been evaluated in randomized, controlled trials, and the number of variables involved in ALA incubation (eg, duration, occlusion, ALA formulation, and strength) and PDT illumination (eg, light source, fluence rate, irradiance, and duration) confounds standardization.Perhaps the most promising modifications to date involve continuous activation of low levels of protoporphyrin IX, the photoactive metabolite of ALA, as well as using shorter incubation times (with or without prolongation of illumination), lower irradiance, and daylight or combined (daylight and conventional) PDT. However, reimbursement of PDT with alternative light sources in the US is hampered by the US Food and Drug Administration (FDA) labeling, which specifies the blue or red light devices approved for use with corresponding marketed ALA 20% solution and 10% gel, respectively. This review summarizes the existing evidence with respect to pain control in patients undergoing ALA-PDT, recommendations from clinical experience, and goals for future research.

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Section: Discussionmentioning

confidence: 99%

“…Both PDT-associated pain and the severity of erythema and edema were significantly lower in patients who received combined vs conventional PDT (Table 1). 20 The primary advantage of daylight PDT is the near painlessness of the procedure. Furthermore, use of the sun as a light source is free of cost and saves clinic space and time.…”

Section: Ala Formulationmentioning

confidence: 99%

The Interventions to Minimize Pain During Photodynamic Therapy With 5-Aminolevulinic Acid for the Treatment of Cutaneous Diseases

Bhatia

2023

JDD

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“…It has been mostly used in the treatment of actinic keratosis, basal cell skin cancer, cutaneous T-cell lymphoma, etc. [50][51][52][53].…”

Section: Photodynamic Therapymentioning

confidence: 99%

Acne Vulgaris—Novel Treatment Options and Factors Affecting Therapy Adherence: A Narrative Review

Tobiasz

Nowicka

Szepietowski

2022

JCM

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Acne vulgaris is an extremely common skin condition, affecting a large population of adolescents, but at the same time, remaining a quite common issue in the group of adult patients. Its complex pathogenesis includes increased sebum secretion, impaired follicular keratinization, colonization of sebaceous glands with Cutibacterium acne bacteria, and the development of inflammation in pilosebaceous units. Although there are many methods of treatment available targeting the mechanisms mentioned above, a large percentage of patients remain undertreated or non-compliant with treatment. Ineffective treatment results in the formation of acne scars, which has a major impact on the well-being and quality of life of the patients. The aim of this publication was a review of available evidence on widely used and novel methods of topical and systemic treatment of acne, additionally including current literature-based analysis of factors affecting patients’ compliance. The strengths and limitations of novel substances for treating acne were discussed. We conclude that an effective acne treatment remains a challenge. A better understanding of current treatment options and factors affecting patients’ compliance could be a helpful tool in choosing a proper treatment option.

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Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review

Arcuri

Ramchatesingh

Lagacé

et al. 2023

IJMS

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Actinic keratosis (AK) is among the most commonly diagnosed skin diseases with potentially life-threatening repercussions if left untreated. Usage of pharmacologic agents represents one of many therapeutic strategies that can be used to help manage these lesions. Ongoing research into these compounds continues to change our clinical understanding as to which agents most benefit particular patient populations. Indeed, factors such as past personal medical history, lesion location and tolerability of therapy only represent a few considerations that clinicians must account for when prescribing appropriate treatment. This review focuses on specific drugs used in either the prevention or treatment of AKs. Nicotinamide, acitretin and topical 5-fluorouracil (5-FU) continue to be used with fidelity in the chemoprevention of actinic keratosis, although some uncertainty persists in regard to which agents should be used in immunocompetent vs. immunodeficient/immunosuppressed patients. Topical 5-FU, including combination formulations with either calcipotriol or salicylic acid, as well as imiquimod, diclofenac and photodynamic light therapy are all accepted treatment strategies employed to target and eliminate AKs. Five percent of 5-FU is regarded as the most effective therapy in the condition, although the literature has conflictingly shown that lower concentrations of the drug might also be as effective. Topical diclofenac (3%) appears to be less efficacious than 5% 5-FU, 3.75–5% imiquimod and photodynamic light therapy despite its favorable side effect profile. Finally, traditional photodynamic light therapy, while painful, appears to be of higher efficacy in comparison to its more tolerable counterpart, daylight phototherapy.

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Combined versus conventional photodynamic therapy with 5‐aminolaevulinic acid nanoemulsion (BF‐200 ALA) for actinic keratosis: A randomized, single‐blind, prospective study

Cited by 3 publications

References 36 publications

The Interventions to Minimize Pain During Photodynamic Therapy With 5-Aminolevulinic Acid for the Treatment of Cutaneous Diseases

The Interventions to Minimize Pain During Photodynamic Therapy With 5-Aminolevulinic Acid for the Treatment of Cutaneous Diseases

Acne Vulgaris—Novel Treatment Options and Factors Affecting Therapy Adherence: A Narrative Review

Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review

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