Szeimies et al

Title: Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study.

Author: Szeimies R M, Karrer S, Radakovic-Fijan S, Tanew A, Calzavara-Pinton PG, Zane C, et al.

Journal Reference: J Am Acad Dermatol 2002;47:258-62. (by clicking on this link you will be leaving this site - Galderma is not responsible for the content)

Objective: to compare the efficacy, safety, patient satisfaction and cosmetic outcomes of photodynamic therapy using topical methyl aminolevulinate (MAL; Metvix^®) with cryotherapy in the treatment of actinic keratosis (AK) lesions.

Design: Two hundred and two adult patients with a clinical diagnosis of AK were included in this European multi-centre, open, comparative trial. Patients were randomised to receive photodynamic therapy (PDT) with MAL(160 mg/g)or standard cryotherapy. Photodynamic therapy was repeated one week later in the case of lesions not located on the face or scalp. Lesion response was assessed at three months.

Key Results:

Overall lesion complete response rates were 69% for MAL-PDT and 75% for cryotherapy.
In both cases response was better for thinner lesions (grade 1) - 80% for photodynamic therapy and 82% for cryotherapy on thin facial lesions.
Cosmetic outcome was significantly better in the PDT group, where 98% of patients rated the outcome as very good or excellent compared with 91% of patients treated with cryotherapy.
Patient satisfaction was very high with photodynamic treatment - 74% of those who had previously received other therapies rated MAL-PDT as better.
Both groups reported local, adverse reactions to treatment. Most events were mild to moderate in intensity and of short duration.

Conclusion: Photodynamic therapy with methyl aminolevulinate cream (MAL; Metvix^®) can be considered as an attractive treatment option for patients with actinic keratosis facial lesions, combining efficacy and improvements in cosmetic outcome over other standard therapies.