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Saenz-Guirado S, Ayen-Rodriguez A, Galvez-Moreno M, Velasco-Amador JP, Llamas-Molina JM, Ruiz-Villaverde R, Molina-Leyva A. Home- vs clinic-based daylight photodynamic therapy with 5-aminolevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis: A randomized, single-blind, prospective study. Photodiagnosis Photodyn Ther 2024; 46:104031. [PMID: 38438001 DOI: 10.1016/j.pdpdt.2024.104031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Daylight photodynamic therapy (DL-PDT) has become one of the most effective treatments for the resolution of actinic keratosis (AK) of Olsen grade 1 and 2. Generally, PDT it is carried out in a clinic setting, which involves the patient's and their caregivers commuting to the hospital as well as a significant use of resources to carry it out within the clinic setting. OBJECTIVES To determine the efficacy and safety of a home-based treatment of AK with DL-PDT with the BF-200 ALA gel compared to a clinic-based setting. METHODS The study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. 9 patients received one clinic-based DL-PDT (group 1) and 11 patients received one session of home-based DL-PDT (group 2). The primary endpoints were the mean AK clearance per patient and the total AK lesion clearance rate 12 weeks after treatment. The secondary endpoints were the number of remaining AKs and new AKs appearing in the treatment field 12 weeks after one PDT session. The pain during and 24 h after PDT as well as the local skin reactions were also assessed. RESULTS The overall reduction of AK lesions per patient was similar in both groups with one PDT session. An overall AK clearance per patient of 10 ± 4.33 for group 1 versus 9.73 ± 2.9 for group 2 without statistically significant differences (p = 0.868). Regarding the clearance rate, although it was slightly higher in group 2 (71.58 ± 22.51 vs 82.1 ± 11.13), the analysis did not show statistically significant differences. The mild pain recorded during the treatment course and the mild local skin reactions were similar in both groups. Patient satisfaction was high for both groups without statistically significant differences. CONCLUSION Self-performed home-based DL-PDT with BF-200 ALA gel is as effective as the one performed in a clinic-based setting, with a comparable safety profile, high levels of patient satisfaction and with advantages for the patients and their caregivers that can enhance patient´s adherence to the treatment.
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Affiliation(s)
- S Saenz-Guirado
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain.
| | - A Ayen-Rodriguez
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
| | - M Galvez-Moreno
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
| | - J P Velasco-Amador
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
| | - J M Llamas-Molina
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain
| | - R Ruiz-Villaverde
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain; Biosanitary Institute of Granada, IBS, Granada, Spain
| | - A Molina-Leyva
- Biosanitary Institute of Granada, IBS, Granada, Spain; Department of Dermatology, University Hospital Virgen de las Nieves, Granada. Spain; Facultad de Medicina. Universidad de Granada, Spain
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Luo OD, Bose R, Bawazir MA, Thuraisingam T, Ghazawi FM. A Review of the Dermatologic Clinical Applications of Topical Photodynamic Therapy. J Cutan Med Surg 2024; 28:NP1. [PMID: 38243786 DOI: 10.1177/12034754231216969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Topical photodynamic therapy is a widely approved therapy for actinic keratoses and low-risk nonmelanoma skin cancers with a rapidly growing range of emerging indications for other cutaneous diseases. This review summarizes the best-available evidence to provide a clinical update for dermatologists on the approved and emerging indications of photodynamic therapy. The body of evidence suggests that photodynamic therapy is superior or noninferior to other available treatment modalities for actinic keratoses, low-risk basal cell carcinomas, Bowen's disease, skin field cancerization, chemoprevention of keratinocyte carcinomas in organ transplant recipients, photoaging, acne vulgaris, and cutaneous infections including verrucae, onychomycosis, and cutaneous leishmaniasis. There is emerging evidence that photodynamic therapy plays a role in the management of actinic cheilitis, early-stage mycosis fungoides, extramammary Paget disease, lichen sclerosis, and folliculitis decalvans but there are no comparative studies with other active treatment modalities. Common barriers to topical photodynamic therapy include procedural pain, costs, and the time required for treatment delivery. There is significant heterogeneity in the photodynamic therapy protocols reported in the literature, including different photosensitizers, light sources, number of treatments, time between treatments, and use of procedural analgesia. Topical photodynamic therapy should be considered in the management of a spectrum of inflammatory, neoplastic, and infectious dermatoses. However, more comparative research is required to determine its role in the treatment algorithm for these dermatologic conditions and more methodological research is required to optimize photodynamic therapy protocols to improve the tolerability of the procedure for patients.
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Affiliation(s)
- Owen Dan Luo
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Reetesh Bose
- Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mohammed A Bawazir
- Division of Dermatology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Thusanth Thuraisingam
- Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Feras M Ghazawi
- Division of Dermatology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montreal, QC, Canada
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The Immunogenetic Aspects of Photodynamic Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:433-448. [DOI: 10.1007/978-3-030-92616-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sáenz-Guirado S, Cuenca-Barrales C, Vega-Castillo J, Linares-Gonzalez L, Ródenas-Herranz T, Molina-Leyva A, Ruiz-Villaverde R. Combined versus conventional photodynamic therapy with 5-aminolaevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis: A randomized, single-blind, prospective study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 38:334-342. [PMID: 34773302 DOI: 10.1111/phpp.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/20/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) has become one of the most effective therapies for the treatment of actinic keratosis, allowing the removal of more than one lesion in a single session. However, the pain sustained by the patient during treatment and local skin reactions can limit its use. OBJECTIVES To determine the efficacy and safety of combined PDT (daylight PDT followed by conventional PDT) vs conventional PDT 12 weeks after treatment. METHODS The study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. A total of 51 patients with grade I and II AKs on the scalp or face were randomized. Twenty-five patients received one session of combined PDT (combPDT), and 26 patients received one session of conventional PDT (cPDT). The primary endpoint was the reduction of AKs, 12 weeks after treatment. The secondary endpoint was the reduction in pain and local skin reaction. RESULTS The reduction rate of grade I and II AKs was similar in combPDT and cPDT, showing no statistically significant differences between both groups, 76.67% vs 86.63% [P = .094] and 80.48% vs 83.08% [P = .679], respectively. However, pain was significantly lower in the combPDT group (2.56 vs 5, P < .01), as were local skin reactions. CONCLUSIONS CombPDT has proven to be as effective as cPDT for the treatment of grade I and II AKs located on the scalp and face. Furthermore, combPDT has been shown to be considerably more tolerable than cPDT, causing only mild local skin reactions.
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Affiliation(s)
| | | | | | | | | | | | - Ricardo Ruiz-Villaverde
- Department of Dermatology, University Hospital San Cecilio, Granada, Spain.,Instituto biosanitario de Granada, IBS, Granada, Spain
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Tabero A, Planas O, Gallavardin T, Nieves I, Nonell S, Villanueva A. Smart Dual-Functionalized Gold Nanoclusters for Spatio-Temporally Controlled Delivery of Combined Chemo- and Photodynamic Therapy. NANOMATERIALS 2020; 10:nano10122474. [PMID: 33321776 PMCID: PMC7763296 DOI: 10.3390/nano10122474] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023]
Abstract
We report the preparation of gold nanoclusters (AuNCs) as a delivery vehicle for the clinically approved photodynamic and chemotherapeutic agents Protoporphyrin IX (PpIX) and doxorubicin (DOX), respectively, and their effect on tumor cells. DOX was attached to the gold nanoclusters through a singlet oxygen-cleavable linker and was therefore released after PpIX irradiation with red light, contributing, synergistically with singlet oxygen, to induce cell death. The doubly functionalized AuNCs proved more effective than a combination of individually functionalized AuNCs. Unlike free DOX, the photoactive nanosystem was non-toxic in the absence of light, which paves the way to introduce a spatiotemporal control of the anticancer therapy and could contribute to reducing the undesirable side effects of DOX.
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Affiliation(s)
- Andrea Tabero
- Departamento de Biología, Universidad Autónoma de Madrid, Darwin 2, 28049 Madrid, Spain
| | - Oriol Planas
- Institut Químic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain
| | | | - Ingrid Nieves
- Institut Químic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain
| | - Santi Nonell
- Institut Químic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain
| | - Angeles Villanueva
- Departamento de Biología, Universidad Autónoma de Madrid, Darwin 2, 28049 Madrid, Spain
- Instituto Madrileño Estudios Avanzados IMDEA Nanociencia, C Faraday 9, 28049 Madrid, Spain
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Salido-Vallejo R, Jiménez-Nájar F, Garnacho-Sucedo G, Vélez A. Combined daylight and conventional photodynamic therapy with 5-aminolaevulinic acid nanoemulsion (BF-200 ALA) for actinic keratosis of the face and scalp: a new and efficient approach. Arch Dermatol Res 2019; 312:675-680. [DOI: 10.1007/s00403-019-02028-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/20/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
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Gutiérrez García-Rodrigo C, Pellegrini C, Piccioni A, Tambone S, Fargnoli MC. Single versus two-treatment schedule of methyl aminolevulinate daylight photodynamic therapy for actinic keratosis of the face and scalp: An intra-patient randomized trial. Photodiagnosis Photodyn Ther 2019; 27:100-104. [DOI: 10.1016/j.pdpdt.2019.05.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/14/2019] [Accepted: 05/24/2019] [Indexed: 01/22/2023]
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