Critical review of the manner in which the efficacy of therapies for rosacea are evaluated

Abstract

For each of the parameters that are commonly used to measure the efficacy of treatments for rosacea, the different approaches by which it has been measured in the various trials have been highlighted; these dissimilarities can make it problematic to compare between clinical trials. A greater degree of uniformity in the manner in which the various parameters are evaluated would enable a more objective comparison between the studies.

Videocapillaroscopic alterations in erythematotelangiectatic rosacea

“…[15][16][17][18] The assessment and monitoring of rosacea is based on clinical judgment, and there are currently no objective instrumental measurements, laboratory tests, or standardized tools for quantifying the severity of the condition. 5,7 Some studies on rosacea have considered skin color changes as a surrogate measurement of vessel changes. 8,19 The majority of trials evaluating erythema and telangiectasia have utilized subjective methods of color measurement and vessel changes.…”

“…5 The development of instrumental techniques is obviously important for a more reproducible disease assessment and may allow a more rigorous comparison between studies, especially on drug efficacy. 7 Erythema and telangiectases have been measured indirectly by assessing color changes. 6,8 Capillaroscopy has been considered superior to indirect technique (eg, laser-Doppler, trans cutaneous PO 2 ) for the clinical investigation of cutaneous microcirculation in various skin diseases.…”

Pimecrolimus 1% cream for the treatment of steroid-induced rosacea: an 8-week split-face clinical trial

“…Clinical parameters included investigator’s global assessment of erythema (IGA‐E) and papules (IGA‐P), total inflammatory lesion counts, proportion of affected areas on each side of the face, and visual analogue scale (VAS). IGA‐E and IGA‐P were graded using a six‐point scale (0, clear; 1, nearly clear; 2, moderate; 3, moderate to severe; 4, severe; 5, very severe) 16,17 . Clinical descriptions of IGA are shown in Table 1.…”

“…IGA-E and IGA-P were graded using a six-point scale (0, clear; 1, nearly clear; 2, moderate; 3, moderate to severe; 4, severe; 5, very severe). 16,17 Clinical descriptions of IGA are shown in Table 1. Assessments of facial erythema, numbers of inflammatory lesions and proportions of affected areas with respect to each side were performed by three dermatologists unaware of treatment allocations, and averaged values were used for the statistical analyses.…”

Epidermal hydration levels in patients with rosacea improve after minocycline therapy

“…Erythema, a prominent clinical feature of rosacea, 22 was measured in parallel with these parameters as an objective indicator of both disease activity and response to therapy. The first was a case-control study, comparing sebum casual levels, pH and hydration levels of the facial skin surface of patients with untreated PPR to findings from control subjects with normal facial skin.…”