Ivermectin: A Review in Rosacea

Ivermectin 1 % cream (Soolantra^®; Rosiver™; Izefla^®) is a novel topical agent indicated for the once-daily treatment of inflammatory lesions of rosacea. Ivermectin is a derivative of the avermectin family of macrocyclic lactone parasiticides. It displays anti-inflammatory properties as well as broad-spectrum anti-parasitic activity, both of which may contribute to its efficacy in treating rosacea. In phase III trials of 12 or 16 weeks’ duration in adults with moderate to severe papulopustular rosacea, once-daily ivermectin 1 % cream improved the symptoms of rosacea (as per Investigator Global Assessment and inflammatory lesion count) and health-related quality of life versus vehicle, and was more effective than twice-daily metronidazole 0.75 % cream in terms of these measures. Ivermectin 1 % cream continues to provide benefit for up to 52 weeks of treatment, according to extension studies, and is well tolerated, with the most common treatment-related adverse events (skin burning sensation, pruritus, dry skin and skin irritation) each occurring with low incidence (<2 %). Thus, ivermectin 1 % cream is an effective and well tolerated option for the topical treatment of inflammatory lesions of rosacea, with the convenience of once-daily application.