Erenumab may reduce flushing, erythema in rosacea
Key takeaways:
- Flushing and erythema were reduced in patients using erenumab, a CGRP receptor antagonist.
- Adverse events were mild and well tolerated; however, larger randomized trials are needed.
Erenumab is potentially efficacious in treating chronic flushing and erythema associated with rosacea, according to a study.
“Rosacea is a common, chronic facial skin disease, often characterized by persistent centrofacial erythema and recurring episodes of painful and debilitating flushing,” Nita Katarina Frifelt Wienholtz, MD, PhD, of the Danish Headache Center at Copenhagen University Hospital-Rigshospitalet, told Healio. “We recently found increased levels of the neuropeptide calcitonin gene-related peptide (CGRP) in the blood of people with rosacea, suggesting that this molecule may be important in rosacea.”
Erenumab is an anti-CGRP-receptor monoclonal antibody.
In this open-label, single-group, nonrandomized study, which Wienholtz said is the first to examine a CGRP-receptor antagonist in rosacea, the researchers enrolled 30 patients (mean age, 38.8 years; 77% women) to receive 140 mg of erenumab every 4 weeks for 12 weeks. Of the total cohort, 27 completed the full study.
Patients reported a mean number of days with moderate to extreme flushing per 4 weeks of 23.6 (standard deviation [SD], 5.8) at baseline. Most subjects (n = 26) reported discontinuing at least one rosacea treatment in the past due to lack of effectiveness or tolerability.
After three erenumab doses, or between weeks 9 and 12, the mean number of moderate to severe flushing days was reduced by 6.9 days (95% CI, 10.4 to 3.4 days). One patient experienced a 50% or more decrease in the number of moderate to extreme flushing days in the first to fourth weeks of treatment from baseline, whereas three had a 50% decrease between weeks 5 and 9 and seven experienced a 50% decrease between weeks 9 and 12.
Rosacea severity, measured by the mean change in moderate to severe erythema days, was 15.2 (SD, 9.1) at baseline and reduced by 8.1 days (95% CI, 12.5 to 3.7 days) between weeks 9 through 12.
Nine subjects experienced at least a 50% reduction in patient self-assessment scores in the first 4 weeks of treatment, 11 between weeks 5 through 8 and 15 between weeks 9 through 12.
At least one adverse event was reported in 25 patients, with constipation (n = 10) and transient worsening of flushing (n = 4) being the most common. Upper respiratory tract infection, headache or migraine transient worsening, dry eyes, intermittent fever and dry skin were also reported in three or fewer patients. Overall, the treatment was well tolerated.
“Erenumab, a CGRP-receptor antagonist, significantly reduced the number of days with moderate to severe flushing and erythema following 12 weeks of treatment,” Wienholtz told Healio. “Our results suggest that CGRP-receptor inhibition holds promise as a treatment approach for rosacea.”