Soolantra is a cream indicated for the topical treatment of inflammatory lesions of papulopustular rosacea in adult patients (>18 years). Soolantra contains ivermectin, which is a member of the avermectin class of anti-parasitic medications. The anti-parasitic effect and ivermectin's anti-inflammatory properties are presumed to make up the mechanism of action in the treatment of papulopustular rosacea.
The effect of Soolantra is well-established in a number of clinical trials, which showed that Soolantra had a superior effect in reducing the severity of rosacea (IGA success) as well as inflammatory lesions compared to both placebo and metronidazole 0.75% cream (Rozex). Efficacy onset is 3-4 weeks after treatment. Also, the patient-related improvement was assessed to be high.
In addition to metronidazole, azelaic acid 15% gel has previously also been authorised for topical treatment of inflammatory papules and pustules in rosacea. Topical treatment is preferred over systemic treatment because topical treatment is associated with fewer adverse reactions and a lower risk of interactions with concurrent medicinal treatment. Long-term use of antibiotics (including topical treatment) is problematic in relation to development of resistance; therefore alternate treatment forms are preferred.
Unlike metronidazole and azelaic acid 15% gel, Soolantra is applied no more than once daily. Most likely this will lead to better compliance.
The treatment price of Soolantra is on a par with metronidazole, but considerably higher than azelaic acid.
It is IRF’s overall assessment that Soolantra can be used as a first-line agent in the treatment of papulopustular rosacea.
Soolantra was marketed on 6 July 2015, and single reimbursement can be applied for at present.