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The Journal of Dermatological Treatment Mar 2021Topical oxymetazoline and brimonidine are the only medications approved for treating persistent facial erythema of rosacea. This review aims to investigate the efficacy,... (Review)
Review
OBJECTIVE
Topical oxymetazoline and brimonidine are the only medications approved for treating persistent facial erythema of rosacea. This review aims to investigate the efficacy, safety, pharmacodynamics, and pharmacokinetic properties of oxymetazoline and brimonidine.
METHODS AND MATERIALS
Phase II and phase III clinical studies evaluating oxymetazoline and brimonidine were assessed to compare their efficacy and safety.
RESULTS
In their respective phase III trials, both oxymetazoline and brimonidine met the primary efficacy outcome of having at least a 2-grade decrease from baseline on both the Clinician Erythema Assessment (CEA) and the Subject Self-Assessment (SSA) Scales compared to the vehicle control. Treatment related adverse events of oxymetazoline and brimonidine are most often mild and localized.
CONCLUSIONS
Topical oxymetazoline and brimonidine are effective for the management of persistent facial erythema associated with rosacea with a few mild and localized adverse effects. Further long-term research is imperative to further understand their long-term effects.
Topics: Administration, Topical; Brimonidine Tartrate; Clinical Trials as Topic; Dermatitis; Erythema; Humans; Oxymetazoline; Rosacea; Treatment Outcome; Vasoconstrictor Agents
PubMed: 31294643
DOI: 10.1080/09546634.2019.1639606 -
Journal of Cosmetic Dermatology Sep 2023Since there is currently no conclusion on the efficacy and adverse effects of oxymetazoline, this meta-analysis attempts to explore its efficacy and adverse events, so... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Since there is currently no conclusion on the efficacy and adverse effects of oxymetazoline, this meta-analysis attempts to explore its efficacy and adverse events, so as to provide guidance for clinical medication.
METHODS
We searched PubMed, Embase, and Cochrane Library from the establishment of the database to May 2021. We included studies that patients were randomly assigned to receive oxymetazoline or vehicle, and we excluded duplicate publications, research without full text, incomplete information or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.
RESULTS
The pooled results show that the 3 (RR = 1.76, 95% CI: 1.53-2.03), 6 (RR = 1.71, 95% CI: 1.47-2.00), 9 (RR = 1.63, 95% CI: 1.40-1.90), 12 (RR = 1.41, 95% CI: 1.18-1.67) -hours CEA success rate and the 3 (RR = 1.65, 95% CI: 1.34-2.03), 6 (RR = 1.75, 95% CI: 1.43-2.14), 9 (RR = 1.63, 95% CI: 1.33-2.00), 12 (RR = 1.78, 95% CI: 1.45-2.18) -hours SSA success rate after oxymetazoline treatment for rosacea is significantly higher than that of vehicle. Additionally, the pooled results show that the incidence of TEAEs after treatment with oxymetazoline is significantly higher than that of vehicle (RR = 1.34, 95% CI: 1.10-1.2). However, our analysis of specific adverse events found that the oxymetazoline group was only significantly higher than the vehicle group in the incidence of application-site dermatitis (RR = 8.91, 95% CI: 1.76-45.23), and there was no statistical significance in the difference in the incidence of other adverse events.
CONCLUSION
Oxymetazoline is effective and can be selected for the treatment of persistent facial erythema of rosacea. Additionally, application-site dermatitis was the most important one.
Topics: Humans; Oxymetazoline; Treatment Outcome; Skin Cream; Rosacea; Dermatitis; Randomized Controlled Trials as Topic
PubMed: 37128814
DOI: 10.1111/jocd.15747 -
JAMA Ophthalmology Nov 2020
Topics: Blepharoptosis; Humans; Oxymetazoline; Randomized Controlled Trials as Topic; Visual Fields
PubMed: 33001145
DOI: 10.1001/jamaophthalmol.2020.3833 -
Expert Review of Clinical Pharmacology Oct 2017Rosacea is a chronic skin condition characterized by transient and persistent erythema of the central face. The symptom of persistent erythema can be particularly... (Review)
Review
Rosacea is a chronic skin condition characterized by transient and persistent erythema of the central face. The symptom of persistent erythema can be particularly frustrating for both patients and physicians as it is difficult to treat. Areas covered: Current treatment options for the treatment of rosacea include metronidazole, azelaic acid, sodium sulfacetamide-sulfur, and brimonidine. Until recently, brimonidine gel was the only option approved specifically for the treatment of facial erythema. However, oxymetazoline hydrochloride 1% cream is a newly FDA approved topical medication for adult rosacea patients. A primarily alpha-1a agonist, oxymetazoline hydrochloride (HCl) is thought to diminish erythema through vasoconstriction. Our paper seeks to evaluate evidence for topical oxymetazoline HCl with respect to its efficacy and safety for its approved indication of treating the persistent erythema associated with rosacea. Expert commentary: While assessment of available clinical trial data indicates that the medication is as effective as other available treatment for controlling rosacea-associated erythema with minimal risk of adverse effects, studies of long-term duration and direct comparison will be necessary to establish its place in treatment guidelines and clinical practice. As further evidence becomes available, the real-world clinical potential of topical oxymetazoline cream will become clearer.
Topics: Administration, Cutaneous; Adrenergic alpha-Agonists; Dermatologic Agents; Erythema; Humans; Oxymetazoline; Rosacea; Skin Cream; Vasoconstriction
PubMed: 28837365
DOI: 10.1080/17512433.2017.1370370 -
Aesthetic Surgery Journal Aug 2023Eyelid ptosis following periocular onabotulinumtoxinA (BoNT-A) treatment is a known complication that can be frustrating for both patients and practitioners. Iatrogenic...
BACKGROUND
Eyelid ptosis following periocular onabotulinumtoxinA (BoNT-A) treatment is a known complication that can be frustrating for both patients and practitioners. Iatrogenic blepharoptosis occurs due to local spread of the BoNT-A from the periocular region into the levator palpebrae superioris muscle. Although injectors should have a thorough understanding of the relevant anatomy in order to prevent it, BoNT-A induced ptosis can occur even in the most experienced hands.
OBJECTIVES
The aim of this study was to describe a case series of patients treated effectively with topical oxymetazoline HCl 0.1% and pretarsal BoNT-A injections in the setting of botox-induced ptosis.
METHODS
The study group consisted of 8 patients who had undergone recent cosmetic BoNT-A treatment preceding the sudden onset of unilateral upper eyelid ptosis.
RESULTS
A diagnosis of severe ptosis (>3 mm) was made in all the cases in this series. Pretarsal BoNT-A injections alone or in association with topical administration of Upneeq eyedrops (Upneeq, Osmotica Pharmaceuticals, Marietta, GA) significantly reversed the ptosis in all treated cases.
CONCLUSIONS
This is the first documented case series of patients treated effectively with topical oxymetazoline HCl 0.1% and pretarsal BoNT-A injections in the setting of botox-induced ptosis. This treatment combination is a safe and effective option in these cases.
Topics: Humans; Botulinum Toxins, Type A; Blepharoptosis; Oxymetazoline; Clostridium botulinum; Neuromuscular Agents
PubMed: 36943792
DOI: 10.1093/asj/sjad070 -
The Annals of Pharmacotherapy Mar 2018To review and summarize topical oxymetazoline's pharmacology, pharmacokinetics, efficacy, safety, cost, and place in therapy for persistent redness associated with... (Review)
Review
OBJECTIVE
To review and summarize topical oxymetazoline's pharmacology, pharmacokinetics, efficacy, safety, cost, and place in therapy for persistent redness associated with erythematotelangiectatic rosacea.
DATA SOURCES
Literature searches of MEDLINE (1975 to September 2017), International Pharmaceutical Abstracts (1975 to September 2017), and Cochrane Database (publications through September 2017) using the terms rosacea, persistent redness, α -agonist, and oxymetazoline.
STUDY SELECTION AND DATA EXTRACTION
Results were limited to studies of human subjects, English-language publications, and topical use of oxymetazoline. Relevant materials from government sources, industry, and reviews were also included.
DATA SYNTHESIS
Data support the efficacy of oxymetazoline for persistent facial redness. Little study beyond clinical trials cited in the drug approval process has been conducted. Current data suggest that oxymetazoline is similar in safety and efficacy to brimonidine. Head-to-head comparisons of topical α-agonists for erythema caused by rosacea are needed.
CONCLUSION
The topical α-agonist, oxymetazoline, is safe and effective for reducing persistent facial redness associated with erythematotelangiectatic subtype of rosacea. Health care practitioners selecting among treatments should consider not only the subtype of rosacea but also individual patient response, preference, and cost.
Topics: Administration, Topical; Adrenergic alpha-Agonists; Drug Interactions; Erythema; Humans; Oxymetazoline; Rosacea; Treatment Outcome
PubMed: 29094614
DOI: 10.1177/1060028017740139 -
Journal of Cosmetic Dermatology May 2022Rosacea is a chronic cutaneous disorder affecting primarily the face, characterized by erythema, transient or persistent, telangiectasia, and inflammatory lesions... (Review)
Review
Rosacea is a chronic cutaneous disorder affecting primarily the face, characterized by erythema, transient or persistent, telangiectasia, and inflammatory lesions including papulo-pustules and swelling. The essential component of the disease is the persistent erythema of facial skin. Episodes of flushing (acute-subacute intermittent vasodilation) are common. Swelling and erythema of the nose along with dilatation of the pilosebaceous poral orifices, known as rhinophyma, can be noted in chronic cases. Rosacea affects up to 10% of the world population and is especially noted in fair-skinned individuals aged 35-50. Women are affected more often than men. Several treatment modalities including topical medications, systemic drugs, lasers, and light-based therapies have been used for the management of rosacea with variable results. Topical medications such as azelaic acid, metronidazole, and sulfacetamide/sulfur, oral antibiotics such as tetracyclines, and oral retinoids alone or, most commonly, in combination form the mainstay of treatment. Light therapies such as intense pulsed light and pulsed dye laser are best used for the erythemato-telangiectatic type. Topical brimonidine, oxymetazoline, ivermectin, tacrolimus, pimecrolimus, low-dose modified-release tetracyclines and botulinum toxin are the new additions to the therapeutic armamentarium. This article provides a comprehensive review of the various therapies used for rosacea.
Topics: Anti-Bacterial Agents; Dermatologic Agents; Erythema; Female; Humans; Male; Oxymetazoline; Rosacea; Telangiectasis; Tetracyclines
PubMed: 35104917
DOI: 10.1111/jocd.14816 -
American Pharmacy May 1985
Topics: Administration, Intranasal; Drug Interactions; Female; Humans; Imidazoles; Oxymetazoline; Pregnancy
PubMed: 4003266
DOI: 10.1016/s0160-3450(16)32692-7 -
American Journal of Therapeutics 2018
Topics: Angina Pectoris; Computed Tomography Angiography; Echocardiography; Humans; Male; Middle Aged; Nasal Decongestants; Nasal Obstruction; Oxymetazoline; Tonsillectomy
PubMed: 28901959
DOI: 10.1097/MJT.0000000000000628 -
Journal of Cosmetic Dermatology Jan 2023Facial persistent erythema is recognized as difficult feature to treat in rosacea. Topical Oxymetazoline cream 1% has been used to treat persistent facial erythema in... (Review)
Review
BACKGROUND
Facial persistent erythema is recognized as difficult feature to treat in rosacea. Topical Oxymetazoline cream 1% has been used to treat persistent facial erythema in rosacea patients for some years.
OBJECTIVE
To quantitatively synthesize the benefits and harms of Oxymetazoline cream 1% in real-world clinical management of treatment response and adverse events.
METHODS
The clinical researches before June 1, 2022 published on online databases including PubMed, Web of Science, Embase and Cochrane Library were meta-analyzed.
RESULTS
A total of 2298 participants were included, and the improvement rate of two-grade Clinician Erythema Assessment score (CEA) and Subject Self-Assessment for rosacea facial redness score (SSA) in Oxymetazoline group was 38% (95%CI 28-48) and 25% (95%CI 22-27), respectively, at the 4th week of the dosing. The comprehensive rate of treatment-related TEAEs in Oxymetazoline group was 7% (95%CI 5-8). The rate of stinging/burning was 15% (95%CI 10-19), pruritus was 15% (95%CI 9-22), dryness was 23% (95%CI 18-28), and scaling was 17% (95%CI 12-22) in analysis of dermal tolerability. And topical Oxymetazoline cream 1.0% presented a very low rebound rate of erythema (1%, 95%CI 0-2).
CONCLUSIONS
These real-world data on Oxymetazoline cream 1% in rosacea-associated erythema may help making clinic decision and informing treatment expectations, and more clinic trials on longer-term dosing or the combination treatment with oral medication and energy-based therapy are worth exploring.
Topics: Humans; Oxymetazoline; Treatment Outcome; Skin Cream; Erythema; Rosacea; Emollients
PubMed: 36237138
DOI: 10.1111/jocd.15467