This article is more than 5 years old. Information may no longer be current.

Microneedle-assisted photodynamic therapy shows efficacy in actinic keratoses

Microneedle pretreatment combined with photodynamic therapy showed efficacy when treating patients with actinic keratoses, and provides a shorter incubation time compared with conventional treatment, according to recently published study results in JAMA Dermatology.

Researchers recruited 33 patients with actinic keratoses (AKs) from a university dermatology outpatient clinic between 2015 and 2016, who were randomly assigned to two cohorts of either a 10-minute (n = 16 patients) or 20-minute (n = 17 patients) aminolevulinic acid incubation times, following a treatment with a microneedle roller (200 um) or a sham roller.

The patients were then exposed to blue light (Bu-U, Dusa Pharmaceuticals) for 1,000 seconds (total fluence, 10 J/cm²).

One patient in the 20-minute incubation cohort withdrew but the 32 others completed the study.  Mean follow-up time was 34.5 days for the 20-minute cohort and 30.2 days for the 10-minute cohort.

The average AK clearance was 76% in the microneedle-treated side compared with 58% on the sham side in the 20-minute incubation cohort (P < .01), including three patients with complete clearance.  The microneedle- and sham-treated sides were not significantly different during pain assessment measured by visual analog scale (0.7 and 0.4, respectively).

In the 10-minute incubation cohort, the microneedle-treated side had an AK clearance of 43% compared with 38% on the sham-treated side, but the difference was not statistically significant. There also was not a significant difference between the microneedle and sham-treated sides in pain during blue light exposure (4.5 mm and 3.4 mm, respectively).

“The results … support efficacy of microneedle pretreatment for short [aminolevulinic acid] incubation time of 20 minutes, similar to conventional [aminolevulinic acid photodynamic therapy] of a 1-hour incubation,” the researchers concluded. “Large-scale randomized clinical trials evaluating microneedle augmentation for shorter photodynamic therapy] incubation times are needed to further validate the observed efficacy of treatment and reduction in patient discomfort.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.