Display options
Share it on

Dermatol Ther (Heidelb). 2015 Sep;5(3):171-81. doi: 10.1007/s13555-015-0078-1. Epub 2015 Jun 26.

The Role of Topical Brimonidine Tartrate Gel as a Novel Therapeutic Option for Persistent Facial Erythema Associated with Rosacea.

Dermatology and therapy

Andrew William Johnson, Sandra Marchese Johnson

Affiliations

  1. Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  2. Johnson Dermatology, Fort Smith, AR, USA. [email protected].

PMID: 26112098 PMCID: PMC4580655 DOI: 10.1007/s13555-015-0078-1

Abstract

Rosacea is a chronic inflammatory skin condition that commonly presents with persistent facial erythema with or without the coincident presence of flushing, telangiectasias, inflammatory papules or pustules, phymatous changes, or ocular involvement. Patients often present with a constellation of various signs and symptoms of the disease, and an individualized treatment plan should be tailored to a patient's unique clinical presentation. Previously available medications for rosacea have all targeted the inflammatory erythematous papules and pustules frequently associated with the disease, leaving a therapeutic gap for the common manifestation of persistent facial erythema. Brimonidine tartrate 0.33% gel was approved by the US Food and Drug Administration in August 2013 as the first medication available for the topical treatment of persistent facial erythema associated with rosacea. Brimonidine gel is a highly selective α2-adrenergic receptor agonist with potent vasoconstrictive effects, which leads to significant reduction of persistent facial erythema in the majority of patients when applied once daily. Based on large-scale clinical trials and post-marketing reports, brimonidine gel has maintained a good safety profile with a minority of patients experiencing adverse effects from its use, most of which are cutaneous in nature, mild-to-moderate in degree, occur early after initiation of treatment, often resolve spontaneously with continued use, and generally resolve after discontinuation of use. Among the reported adverse effects, two distinct manifestations of worsened erythema have been described. Brimonidine gel can be integrated into a treatment regimen along with concomitant therapies for facial papules and pustules with no increased risk of adverse events with combination therapy. Education about optimal application methods, setting reasonable expectations for treatment, and minimizing inflammation are important factors for the successful use of brimonidine gel as part of a patient's overall rosacea treatment regimen.

Keywords: Brimonidine; Erythema; Flushing; Gel; Mirvaso; Redness; Rosacea; Topical; Treatment

References

  1. Br J Dermatol. 2013 Sep;169(3):555-62 - PubMed
  2. Cutis. 2013 Mar;91(3 Suppl):1-8 - PubMed
  3. J Drugs Dermatol. 2004 Jul-Aug;3(4):427-31 - PubMed
  4. Br J Dermatol. 2014 Jul;171(1):162-9 - PubMed
  5. J Drugs Dermatol. 2015 Jan;14(1):33-40 - PubMed
  6. Am J Clin Dermatol. 2000 May-Jun;1(3):191-9 - PubMed
  7. J Manag Care Spec Pharm. 2014 Jun;20(6):623-9 - PubMed
  8. J Clin Aesthet Dermatol. 2012 Mar;5(3):26-36 - PubMed
  9. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S211-4 - PubMed
  10. Cutis. 2014 Mar;93(3):134-8 - PubMed
  11. J Drugs Dermatol. 2013 Jun 1;12(6):650-6 - PubMed
  12. Cutis. 2013 Nov;92(5):234-40 - PubMed
  13. J Dermatolog Treat. 2015;26(4):379-80 - PubMed
  14. J Am Acad Dermatol. 2014 Feb;70(2):e37-8 - PubMed
  15. J Clin Aesthet Dermatol. 2012 Mar;5(3):16-25 - PubMed
  16. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S44-56 - PubMed
  17. J Drugs Dermatol. 2014 Jan;13(1):56-61 - PubMed
  18. J Drugs Dermatol. 2012 Jun;11(6):694-700 - PubMed
  19. Am J Ophthalmol. 1999 Jan;127(1):20-6 - PubMed
  20. Cutis. 2004 Jan;73(1 Suppl):29-33 - PubMed
  21. J Am Acad Dermatol. 2014 Oct;71(4):832-3 - PubMed
  22. Arch Dermatol. 2007 Nov;143(11):1369-71 - PubMed
  23. J Am Acad Dermatol. 2002 Apr;46(4):584-7 - PubMed
  24. Br J Dermatol. 1986 Nov;115(5):551-6 - PubMed
  25. J Dermatol Sci. 2014 Jul;75(1):49-54 - PubMed
  26. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S15-26 - PubMed
  27. J Am Acad Dermatol. 2014 May;70(5):e109-10 - PubMed
  28. J Eur Acad Dermatol Venereol. 2011 Feb;25(2):188-200 - PubMed
  29. Surv Ophthalmol. 1996 Nov;41 Suppl 1:S39-47 - PubMed
  30. Cutis. 2013 Dec;92(6):277-84 - PubMed
  31. Br J Dermatol. 2012 Mar;166(3):633-41 - PubMed
  32. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S1 - PubMed

Publication Types