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. 2008 Jul;1(2):22-7.

Considerations for use of Fluorouracil cream 0.5% for the treatment of actinic keratosis in elderly patients

William Philip Werschler  1
Affiliations

Considerations for use of Fluorouracil cream 0.5% for the treatment of actinic keratosis in elderly patients

William Philip Werschler. J Clin Aesthet Dermatol. 2008 Jul.

Abstract

Actinic keratosis (AK), the initial lesion in a disease continuum that may progress to squamous cell carcinoma, often begins with ultraviolet B light-induced photo damage and increases in prevalence with age. Topical 5-fluorouracil (5-FU) for the treatment of widespread multiple AK lesions has cure rates of more than 90 percent. The associated skin irritation, however, may lead patients to prematurely discontinue treatment. To improve treatment efficacy and tolerability, 5-FU cream 0.5%, a novel Microsponge(®)-based formulation, was developed. In the elderly population, 5-FU cream 0.5% may be preferable because of its convenient (once daily) administration and its lower potential for irritation and systemic absorption, which may impact adherence to therapy and, thus, possibly increase cure rates.

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Figures

Figure 1
Figure 1
Typical presentation of a patient with actinic keratosis lesions. (Photo courtesy of Dermnet.com.)
Figures 2A and 2B
Figures 2A and 2B
Shown are (A) the least squares mean and (B) the mean percentage reductions in actinic keratosis lesions for 5-FU cream 0.5% and vehicle control. Footnotes: (A) *Least squares mean is a method of predicting the difference between observed and predicted response for a variable that is a function of ≥1 independent variables. †P<.001 versus vehicle control. ‡P<.001 versus 5-FU cream 0.5% for one week. §P=.016 versus 5-FU cream 0.5% for two weeks. (B) *P<.001 versus vehicle control. (Figure 2A Reprinted with permission from Cutis. 2002;70:335–339. ©2002 Quadrant HealthCom.)
Figures 2A and 2B
Figures 2A and 2B
Shown are (A) the least squares mean and (B) the mean percentage reductions in actinic keratosis lesions for 5-FU cream 0.5% and vehicle control. Footnotes: (A) *Least squares mean is a method of predicting the difference between observed and predicted response for a variable that is a function of ≥1 independent variables. †P<.001 versus vehicle control. ‡P<.001 versus 5-FU cream 0.5% for one week. §P=.016 versus 5-FU cream 0.5% for two weeks. (B) *P<.001 versus vehicle control. (Figure 2A Reprinted with permission from Cutis. 2002;70:335–339. ©2002 Quadrant HealthCom.)
Figure 3
Figure 3
Overall severity and time course of facial irritation for 5-FU cream 0.5% during 1, 2, and 4 weeks of treatment. Severity ratings are based on the following scale: 0 = none, 1 = mild, 2 = moderate, 3 = severe. (Reprinted with permission from Cutis. 2002;70:335–339. ©2002 Quadrant HealthCom.)
Figure 4
Figure 4
Percentage of patients with clearance of AK lesions in all treatment areas. TC1 = Treatment Cycle 1; TC2 = Treatment Cycle 2; TC3 = Treatment Cycle 3. P=.002 at TC1, P<.001 at TC2, and P=.028 at TC3 versus the vehicle control group.
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References

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