As actinic keratosis cases increase, so do potential treatment options

MIAMI BEACH, Fla. — Emerging treatments for actinic keratosis promise a brighter future for patients as phase 2 trials show high efficacy rates, according to a presenter at South Beach Symposium.

“Actinic keratosis is probably still one of the most common dermatological cases,” Todd Schlesinger, MD, FAAD, director, Dermatology and Laser Center of Charleston, Clinical Research Center of the Carolinas, said during his presentation.

In just 20 years, the clinical prevalence of actinic keratoses (AK) has increased from 4.9 million office visits per year to 5.2 million visits per year, according to Schlesinger.

Not having a universal classification system for the disease makes treatment challenging, Schlesinger said, as does incomplete treatment guidelines and case-specific recommendations.

Schlesinger reviewed current treatment options that are available for AK, including cryosurgery, aminolevulinic acid photodynamic therapy and methyl aminolevulinate photodynamic therapy. The two photodynamic therapies can be paired with adapalene 0.1% gel and calcipotriol, respectively, for swifter and more efficient outcomes. The newest treatment for AK is 1% tirbanibulin ointment, which was approved by the FDA in 2020.

Although Schlesinger reported that data is lacking on emerging treatments, he said that there are currently two topical treatments for AK that completed phase 2 trials. The first is VDA 1102 topical ointment. When applied twice daily for 12 weeks, VDA 1102 at 10% intervention reduced lesions by 36% and at 20% intervention reduced lesions by 37%.

Resiquimod also completed a phase 2 trial during which its 0.03% and 0.01% topicals were evaluated. Although the 0.03% formulation showed the greatest efficacy, it was not favored over the 0.01% gel due to 59% of patients experiencing adverse events. Overall, 56% to 85% of resiquimod-treated patients showed skin clearance.

Additionally, Schlesinger said, two more investigational drugs, SR-T100 gel and DFD-07 cream, are currently in phase 2 trials as potential treatments for AK.

“AK is on the rise,” Schlesinger concluded. “We’re continuing to do a lot of research on it and of course I’m glad to see it starting to come into the light in dermatology and hope to see progress in the future.”