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Cream compares to lasers for wrinkle relief, expert says. (Affordable Topical Treatment).

MAUI, HAWAII--Tazarotene cream 0.1% for the treatment of photoaged skin yields long-term results comparable with lasers and other big-ticket high-tech therapies, Dr. Emil A. Tanghetti said at the annual Hawaii dermatology seminar sponsored by the Skin Disease Education Foundation.

"I think here in tazarotene we have something that can compete very, very favorably with these lasers and light devices. And it's something that is really at no cost to you and is actually very economical for your patients," said Dr. Tanghetti of the University of California, Davis.

Indeed, when he analyzed the monthly cost of the various topical therapies used by acne patients in his own practice, he determined that tazarotene cream 0.1% (marketed by Allergan Skin Care as Tazorac for acne and psoriasis and Avage for photoaged skin) costs an average of slightly more than $15. The other topical antiacne agents were two to three times more expensive on a monthly basis because patients had to utilize larger amounts.

"I would extrapolate from this experience in acne patients to say that when we're talking about photodamage, tazarotene cream has got to be one of the most cost-effective treatments we have," said Dr. Tanghetti, whose talk was sponsored by Allergan Skin Care.

Dr. Tanghetti was a coinvestigator in a major Allergan-sponsored multicenter, double-blind, randomized clinical trial in which 568 patients with photoaged skin applied tazarotene cream 0.1% or its vehicle once daily for 6 months. The findings played a key role in earning the photoaged skin indication late last year.

Improvement was observed early on with the retinoid. After 8 weeks, 55% of the tazarotene group showed at least a one-grade improvement in facial mottled hyperpigmentation. After 26 weeks, 54% of retinoid-treated patients showed at least a one-grade improvement--for example, from moderate to mild, or severe to moderate--and another 28% improved by two or more grades. In contrast, 30% of vehicle-treated patients showed a one-grade improvement; 10% improved two or more grades.

The study was extended for another 6 months during which all participants received tazarotene cream open label. Further significant improvements in mottled hyperpigmentation and fine wrinkling were' documented during the second 6 months of therapy. Significant improvements were noted in other dimensions of photoaging: lentigines, elastosis, and coarse wrinkling. However, pore size showed no continued improvement once unplugging occurred in the first weeks of therapy, and telangiectasias were unchanged.

Dr. Tanghetti added that he would anticipate continued improvement in selected aspects of photoaging were the trial to be further extended.

"Photodamage does not occur quickly and will certainly not be reversed quickly. I think maybe 2 years would be a more critical end point for elastosis or coarse wrinkling," Dr. Tanghetti said.

Tazarotene cream 0.1% is the first retinoid where increased irritation isn't the required price for improved effectiveness, he added. Skin irritation is comparable with that of adapalene cream--the least irritating of the topical retinoids--while the efficacy in treating photoaging is unparalleled, he said.

Dr. Tanghetti is an investigator in an ongoing randomized, double-blind trial comparing tazarotene with tretinoin cream (Renova), the other FDA-approved treatment for photoaged skin. His summary of the interim analysis of the first 157 patients--more than half of total enrollees--to complete 6 months of therapy: "Both drugs work. Tazarotene works better and a little faster."
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Title Annotation:tazarotene cream
Author:Jancin, Bruce
Publication:Family Practice News
Geographic Code:1USA
Date:Apr 1, 2003
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