Subantibiotic Dose of Oral Doxycycline Shows Efficacy for Treating Rosacea

A 52-week study demonstrated that a subantibiotic dose of oral doxycycline was efficacious in reducing symptoms of inflammatory rosacea. The results were published in Dermatologic Therapy.

The study was split into two parts, with an initial 12-week phase and a second 40-week phase, to assess the therapy’s relapse and efficacy over long-term use. In the first phase, a multicenter, open-label study, adults with moderate or severe inflammatory papules and pustules of rosacea received a 40-mg dose of oral modified release doxycycline and topical metronidazole gel 1%. Following successful completion of the first phase, patients were then randomized to receive either the experiment treatment or placebo capsules in a multicenter, double-blind, placebo-controlled study.

At study initiation, 235 patients were enrolled. At the completion of part one, 65 patients in the treatment group and 65 patients in the placebo group met the definition of treatment success at week 12 and were enrolled in part two of the study. After the secondary 40-week study, only 9 (13.8%) patients in the treatment group relapsed vs 18 (27.7%) in the placebo group. The investigators also noted significant differences in the median change in inflammatory lesion counts, and stinging/burning also improved more in the treatment group. Adverse events during the study were generally mild or moderate.

Based on the evidence, the subantibiotic dose oral doxycycline demonstrated successful treatment of moderate to severe rosacea in adults.

Reference
Del Rosso JQ, Brantman S, Baldwin H. Long-term inflammatory rosacea management with subantibiotic dose oral doxycycline 40 mg modified-release capsules once daily. Dermatol Ther. Published online October 29, 2021. doi:10.1111/dth.15180