Can proteasome inhibitors effectively treat rosacea?
Clinical Applications
Dr. Schwarzenberger is the former physician editor of DermWorld. She interviews the author of a recent study each month.
By Kathryn Schwarzenberger, MD, FAAD, October 1, 2021
In this month’s Clinical Applications column, Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Jack Arbiser, MD, PhD, FAAD, about his recent Journal of Drugs in Dermatology paper, "Evaluation of a First-in-Class Proteasome Inhibitor in Patients with Moderate to Severe Rosacea."
DermWorld: You and your colleagues recently published a study looking at a novel treatment for rosacea. Can you tell us about your new drug and why you thought it might be effective for treating rosacea?
Dr. Arbiser: We initially started this study because a family friend told us that mate tea was causing benefit for a friend of hers with HIV, and she wanted me to look for the active principles. We found the active principles by looking for fractions that blocked the growth of endothelial (blood vessels) cells. Because these compounds are hard to obtain, we found a synthetic compound that was structurally similar. Given that rosacea is partially a disease of abnormal blood vessels and that there is a great need for novel therapies for rosacea, we chose rosacea as our initial target.
DermWorld: Is this drug commercially available, or do you anticipate it becoming so in the near future?
Dr. Arbiser: With funding or a partnership with a large pharmaceutical company, it could be commercially available in two to three years.
DermWorld: Are proteosome inhibitors being used to treat any other dermatologic conditions, or any health conditions otherwise? Can you think of any others where it would make sense to try it?
Dr. Arbiser: Proteasomes are not targeted in any other skin disorder to our knowledge. We believe that our product would be efficacious against acne, given its similarity to rosacea. Given that proteasome inhibition also lowers levels of mutant p53, it may be of benefit as a non-irritating treatment for actinic keratoses.
DermWorld: Your study was also somewhat unique in its design. Can you describe how you used imaging as part of your study and comment on whether you see newer types of imaging being used more for management of inflammatory skin diseases?
Dr. Arbiser: We included Canfield imaging as it is an objective measure, rather than investigator global assessment (IGA) which is subjective. The use of Canfield imaging allowed us to show strongly decreased erythema in our treatment arms compared to vehicle arms. We believe that future trials will require objective measurements such as Canfield imaging.
Disclaimer: The views and opinions expressed in this article do not necessarily reflect those of DermWorld.
